A 50-year-old man was admitted to our hospital with complaints of effort angina for 2 months. There were no risk factors for coronary artery disease other than smoking. Vital signs and physical examination were normal. According to positive stress test, coronary angiography was recommended for the patient. The left and right selective coronary angio-gram showed no significant atherosclerotic disease. A marked first septal artery (FSA) originating from the left main coronary artery (LMCA) was seen (O Fig. 1, 2). Medical treatment was recommended for the patient.
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