Cardiac

The most likely diagnosis in this 50-year-old male is, well, you have coronary CTA, and what you notice is the patient's

right coronary artery arises off the left cusp.

It tracks between the ascending aorta and the left ventricle. You can see it nicely here as well on the 3D mapping.

This is not a coronary artery dissection. It's not right coronary artery stenosis or LED stenosis.

It's an anatomic variation with the right coronary arising off the left cusp.

And again, in this case, this is what's considered a malignant variation because the right coronary can be compressed between the

left ventricle and the ascending aorta. Just a really nice example.