Anomalous origin of the right coronary artery may lead to myocardial ischemia despite the absence of atherosclerosis. We report the case of a 52-year-old man who was admitted to our hospital with exertional chest discomfort and palpitations. An anomalous origin of the right coronary artery was demonstrated by coronary angiography. There was no evidence of atherosclerosis in either the left or right coronary arteries. However, detailed information regarding the proximal portion of the anomalous artery was not acquired by coronary angiography. In this patient, ultrafast computed tomography (UFT) revealed an acute angle takeoff of the anomalous right coronary artery from the aorta. Furthermore, the proximal portion of the right coronary artery traversed the aorta and pulmonary trunk. This case illustrates that UFT is useful for detecting an anomalous origin of the coronary arteries and evaluating the mechanism of myocardial ischemia in patients with anomalous origin of the coronary arteries.
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