A 41-year-old Chinese man with a background history of hypertension for 8 years underwent a computed tomography coronary angiography for an evaluation of atypical central chest pain. This revealed a coronary artery calcium score of zero with no significant stenosis seen in any of the coronary arteries. There was an incidental finding of a 9 x 6 mm filling defect attached to the right coronary cusp of the aortic valve, projecting into the non-coronary sinus (Figs. 1 and 2).
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