Anomalous right coronary artery arising from left coronary sinus in two brothers

We report two brothers aged 61 and 69 respectively with abnormal right coronary artery (RCA) origin ating from the left sinus of Valsalva. Both of them presented with exertional dyspnea and chest tightness in their seventh decade. Another younger brother of theirs suffered from sudden cardiac death at the age of 60. Other symptomatic family members were screened by multi-slice computed tomography (MSCT), but no coronary artery anomalies were found. Considering different risk factors of these two brothers, one patient underwent coronary artery bypass surgery, while another took medical therapy. Previously reported familial cases of anomalous coronary arteries are very rare.