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Acute coronary syndrome with a malignant course of an unobstructed coronary artery
  1. S S Hothi1,2,3,
  2. A Ali2,
  3. D Cox2
  1. 1Murray Edwards College, University of Cambridge, Cambridge, UK
  2. 2Heart Centre, Northampton General Hospital, Northampton, UK
  3. 3Physiological Laboratory, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr S S Hothi, Murray Edwards College, University of Cambridge, Cambridge CB3 0DF, UK; ssh26{at}

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A 60-year-old woman with no modifiable coronary risk factors presented with a second, inferolateral, non-ST elevation myocardial infarction within 8 months. Her prior angiogram in a different institution revealed intraluminally unobstructed coronaries. Repeat coronary angiography revealed a right coronary artery (RCA) arising from the left coronary sinus, anterior to the aorta in the right anterior oblique (RAO) view (figure 1 and see online supplementary video). An intra-arterial course was therefore suspected, with the RCA running between the …

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