JOURNAL OF CASE REPORTS 2014;4(1):206-208 Emrah Ermis, Emrah Ipek, Selami Demirelli From the Department of Cardiology, Erzurum Training and Research Hospital, Erzurum, Turkey. Double Right Coronary Artery Arising From Separate Ostia Journal of Case Reports, Vol. 4, No. 1, Jan-June 2014 206 Abstract: We present a rare case of double right coronary artery (RCA) arising from separate ostia. A 62 years old male patient was admitted with acute onset retrosternal chest pain. ECG was suggestive of sinus rhythm with intraventicular conduction delay and pathological q waves in D3 and avF derivations without any signifcant ST segment elevations. In the coronary angiography, we detected double RCA, each had its own ostium arising separately from right aortic sinus with complete occlusion seen in one RCA. Plaques were present in left coronary arterial system. Guidewires could not be passed in the completely occluded right RCA and conservative therapy was recommended. Double RCA is a congenital coronary anomaly with a potential of atherosclerotic coronary artery disease which needs regular monitoring. Key words: Coronary Artery Disease, Chest pain, Coronary Angiography, Congenital, Heart Defects, Sinus of Valsalva Corresponding Author: Dr. Emrah Ermis Email: emr_ermis@hotmail.com Received: April 14, 2014 | Accepted: May 28, 2014 | Published Online: June 15, 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0) Confict of interest: None declared | Source of funding: Nil | DOI: http://dx.doi.org/10.17659/01.2014.0052 Introduction Congenital coronary anomalies are seen in 1% of the general population [1]. Unless diagnosed these anomalies constitute a major problem for invasive cardiologists and cardiovascular surgeons. Double right coronary artery (RCA) arising from single or seperate ostia is one of the rarest anomaly in the literature and all of them were mentioned only in case reports [2]. Individuals with double RCA can be unaware of their conditions and are under risk of unpredictable complications due to coronary artery disease or cardiovascular surgery until being diagnosed during coronary angiography or cardiac surgery. Herein we report a patient with double RCA who was admitted to our emergency clinic with the symptoms of unstable angina pectoris. In the coronary angiography we detected double RCA originating from right aortic sinus separately and one of them was totally occluded. Case Report A 62 years old male patient was admitted to our emergency clinic early in the morning with the complaint of retrosternal chest pain of 20 minutes duration. He was a non-smoker and he had a one month history of chest pain, which was sometimes precipitated by effort. His past history was suggestive of hypertension, hyperlipidemia and