Coronary artery tortuosity (CAT) is an anatomical anomaly in which the coronary arteries contain kinks or coils. It is usually found incidentally in elderly patients with long-standing uncontrolled hypertension. This case illustrates a 58-year-old female marathon runner who was found to have CAT, originally presenting with chest pain, hypotension, presyncope, and a severe cramping sensation in her legs.
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