# Anomalous Origin and Course of the Right Coronary Artery Misdiagnosed as Catheter-Induced Ascending Aortic Dissection

## TL;DR

A man with chest pain was misdiagnosed with aortic dissection, but instead had an unusual heart artery structure that was successfully treated with surgery.

## Contribution

Highlights a rare anatomical anomaly of the right coronary artery misdiagnosed as iatrogenic aortic dissection.

## Key findings

- The patient had an anomalous origin and interarterial/intramural course of the right coronary artery.
- No aortic dissection was found during surgery, leading to a successful coronary artery bypass graft.
- The case emphasizes the importance of considering anatomical variations in coronary artery disease diagnosis.

## Abstract

A 55-year-old man was admitted for elective coronary angiography because of exertional chest pain. The angiogram revealed significant disease in the left anterior descending artery and the right coronary artery (RCA). Catheter-induced iatrogenic aortic dissection from the RCA ostium extending into the ascending aorta was suspected. During surgery, there were no signs of aortic dissection, but an anomalous origin of the RCA with an interarterial and intramural course was detected. The patient underwent a successful coronary artery bypass graft surgery.