RT Journal Article SR Electronic T1 Anomalous Coronary Artery Found in the Syncopal Workup of an Elderly Man JF The Journal of the American Board of Family Medicine JO J Am Board Fam Med FD American Board of Family Medicine SP 541 OP 546 DO 10.3122/jabfm.2012.04.110319 VO 25 IS 4 A1 Oommen, Ronnie A1 Wilkins, Thad A1 Chen, Stephen Y. A1 Arora, Vishal YR 2012 UL http://www.jabfm.org/content/25/4/541.abstract AB Syncope, defined as a transient loss of consciousness, is seen in 1% of all visits to emergency departments and urgent care clinics in the United States. Syncope is categorized as cardiogenic, neurologic, or psychogenic. Anomalies of the coronary arteries are rare, and anomalous coronary arteries present as syncope more often in the young than in the elderly; syncope rarely occurs in patients 65 years of age and older. There are 2 major variants of coronary anomalies. In the first variant, the left main coronary artery arises from the right aortic sinus. In the second variant, the right coronary artery arises from the left aortic sinus. The risk of sudden death is higher in patients with the left coronary artery arising from the right aortic sinus. We present a case of an anomalous coronary artery discovered during the syncopal workup in a 66-year-old man because no such cases have been published in the United States. We will discuss the management of anomalous coronary arteries as well as a systematic approach to the diagnosis and management of syncope.