Intra-atrial Course of the Right Coronary Artery: A Report of a Rare Case

TL;DR

A rare case of a right coronary artery running through the heart's atrium is reported, highlighting its importance for avoiding complications during cardiac procedures.

Contribution

This report adds a rare anatomical variant of the right coronary artery to the clinical literature.

Findings

A 69-year-old man was diagnosed with an intra-atrial right coronary artery via MDCTA.

The patient had no significant coronary artery stenosis and was managed conservatively.

The anomaly was asymptomatic but requires recognition to prevent injury during cardiac interventions.

Abstract

Coronary artery anomalies (CAAs) are congenital variations involving the origin, course, or termination of coronary arteries. Among these, an intra-atrial course of the right coronary artery (RCA) is a rare anatomical variant with significant clinical implications, particularly during interventional or surgical procedures. We report the case of a 69-year-old man who presented with chest discomfort and was diagnosed with an intra-atrial RCA using multi-detector computed tomography angiography (MDCTA). Although typically asymptomatic, this anomaly warrants recognition to avoid inadvertent injury during cardiac interventions such as catheterization, pacemaker implantation, or surgery. MDCTA revealed no significant coronary artery stenosis, and the patient was managed conservatively without invasive coronary angiography.

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