An 80-year-old woman was admitted to the cardiology unit due to ongoing chest pain and shortness of breath. Twelve-lead electrocardiography showed unremarkable findings. As she had ongoing angina and high risk due to her age and history of diabetes, coronary angiography was planned. Coronary angiography revealed a very dense and calcified aortic arch and right coronary artery (RCA) (Figure 1, Video 1). However, we were unable to visualize the RCA, due to severe calcification obstructing the ostium of the artery. There were also severe lesions in the left coronary system. The decision was made in favor of coronary artery bypass grafting; however both the patient and her family members refused this decision and opted to carry on medical treatment. The patient was discharged on the second day of her admission.

Figure 1: Fluoroscopic images during coronary angiographic examination showing a very clear dense calcification of aortic arch and right coronary artery.

This case demonstrates a very impressive image of severe calcification of the aortic arch and right coronary artery.

Declaration of conflicting interests
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

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