Split right coronary artery: its definition and its territory.

Area of Science:

• Cardiology
• Anatomical Variations
• Vascular Biology

Background:

• The right coronary artery (RCA) typically supplies the right ventricle and inferior wall of the left ventricle.
• Anatomical variations in coronary artery origins and branching patterns can influence myocardial perfusion and clinical presentation.
• The 'split RCA' or 'double right coronary artery' is a rare anomaly with implications for coronary artery disease management.

Observation:

• A 64-year-old male presented with symptoms indicative of acute myocardial infarction.
• Diagnostic imaging revealed an anomalous split right coronary artery (RCA).
• The anterior bifurcation of the split RCA was occluded.

Findings:

• The occlusion affected a significant territory, causing an infarct in the inferoseptal left ventricular wall.
• The infarct also extended to the anterior right ventricular free wall.
• This case illustrates the territory supplied by the anterior bifurcation of a split RCA.

Implications:

• Understanding the territory of anomalous coronary artery branches is crucial for accurate diagnosis and treatment of myocardial infarction.
• This case highlights the importance of recognizing split RCA anomalies to prevent misdiagnosis and ensure appropriate management.
• Further anatomical studies are needed to fully delineate the clinical significance of split RCA variations.