Varying clinical presentations of anomalous origin of the left main coronary artery from the right coronary sinus with an interarterial course in adults

The diagnosis of anomalous origin of the left main coronary artery from the right coronary sinus with an interarterial course in children and adolescents is considered life-threatening and clinical guidelines recommend surgical correction. The prognostic implications of this diagnosis in adults are not clear. This anomaly may present in adults as sudden cardiac death or may be diagnosed incidentally. Treatment of this anomaly in adults should be tailored individually taking into account the clinical presentation and patient characteristics. •Anomalous origin of the left main coronary artery with an inter-arterial course is considered life-threatening.•In adults, this anomaly has a spectrum of possible clinical manifestations.•Treatment of this anomaly in adults should be tailored individually.