Congenital coronary anomalies are not uncommon and consideration should be given to screening first degree relatives

Nishida et al.1 reported a case of sudden death related to the presence of a high takeoff left coronary artery in the June issue of Pathology. They cite Yamanaka and Hobbs’2 report of five cases (0.004%) of high takeoff coronary ostium amongst 126,595 coronary arteriograms over a 28 year period. However, Yamanaka identified a total of 1686 congenital coronary anomalies (CCAs; 1.33%), of which 327 (0.26%) were considered to be potentially serious, highlighting that CCAs are not a rare finding in adults undergoing coronary arteriography.