Anomalous coronary arteries are rare but potentially life threatening abnormalities of the coronary circulation. Many ofthe variations can be benign in nature; however, some may lead to myocardial ischemia and/or sudden cardiac arrest.1 The most common anomalies described in the medical literature involve branches of the left coronary artery, with the left circumflexartery originating from the right sinus of Valsalva being the most prevalent. Patients may present at any age with symptoms ranging from syncope to sudden cardiac death. Here we present a case of a patient with anomalous right coronary arterycirculation (RCA) who presented with atypical chest pain.