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"Four vessel disease": A case of diseased double split right coronary artery

Coronary artery anomalies (CAAs) are assorted group of congenital disorder whose nomenclature, manifestations, and pathophysiological mechanisms are highly inconsistent. The prevalence of congenital anomalies of the coronary arteries is reported to be approximately 0.6%-1.3% of the general population. Of them, double right coronary artery (RCA) is one of the rarest coronary anomalies . In this case, double split right coronary arteries are diseased with these other two left-sided arteries are also having atherosclerosis disease with significant stenosis, labeling this patient as having "Four vessel disease." If this anomaly had gone undiagnosed or missed, the patient′s symptoms would have been recurred despite revascularization.