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Anomalous left anterior descending artery: an uncommon cause of ST elevation myocardial infarction. A healthy 32-year-old Asian man presented in emergency with a history of severe chest pain. ECG showed normal sinus rhythm with ST elevations in the anterior chest leads. He was diagnosed with anterior wall ST segment elevation myocardial infarction and was thrombolysed with tenecteplase. The cardiac enzymes and troponin level were significantly high and echocardiography demonstrated akinetic anterior segment of left ventricle. Coronary angiography exhibited anomalous left anterior descending artery originating from right sinus of Valsalva without atherosclerotic lesion.