Anomalous origin of left coronary artery from the left ventricle.

A 54-year-old asymptomatic woman (M.H.S.), was referred to the Hospital das Clínicas da Universidade Federal de Minas Gerais (HC/UFMG) cardiology service for routine cardiological evaluation in 2006. The physical examination and basal ECG were normal. Exercise stress testing showed unspecific ST segment alteration, and technetium scintigraphy was normal. One year later, repeat examination showed normal basal ECG, discrete displacement of ST segment by exercise stress testing, and transient ischemic alteration in apical area by technetium perfusion imaging. Injection in the right coronary showed dilation with collateral vessels to the left coronary artery and a hypoplastic left descendent artery (Figure 1, Video 1). The anomalous origin of the left coronary artery from the left ventricle could be seen by the flow from left coronary artery to left ventricle in