Intramural segment with no ischaemia in a patient with an intramural segment of an AAORCA (A and B, asterix), there is normal rest and stress perfusion (C). Intramural segment with no ischaemia in a patient with an intramural segment of an AAORCA (A and B, asterix), there is normal rest and stress perfusion (C). The patient has been managed conservatively. AAORCA, anomalous aortic origin of the right coronary artery; PET, positron emission tomography. Paul C Cremer et al. Open Heart 2016;3:e000490 ©2016 by British Cardiovascular Society