Coronary vessel anomaly is a rare disease, with an incidence of about 0.6-1.3% of patients receiving coronary angiography. The ischemia in coronary vessel anomalies is due in most cases to atherosclerosis or compression of the coronary artery by a great vessel, but occasionally spasm of a coronary vessel anomaly is responsible for the pathogenesis of chest pain and myocardial ischemia. A 64-year-old female presented with a one-year history of effort angina. The left circumflex artery originated from the proximal right coronary artery. There was no atherosclerotic lesion in the right and left coronary arteries, but a focal spasm in the right coronary artery by ergonovine. In a patient with chest pain and coronary artery anomaly, if there is no coronary atherosclerosis, abnormal course or compression, the spasm test of the coronary artery should be documented.