Split right coronary artery: a report of two cases

Area of Science:

• Cardiology
• Congenital Heart Disease
• Anatomical Variations

Background:

• Congenital anomalies of the coronary arteries are uncommon but can lead to significant cardiovascular issues.
• A split right coronary artery (RCA) is a specific anomaly where the RCA originates abnormally from the aorta.
• Understanding these variations is crucial for accurate diagnosis and management of cardiac conditions.

Observation:

• The study presents two cases of split RCA in adult patients (59-year-old male, 50-year-old female).
• Both patients presented with symptoms of exercise-induced angina pectoris.
• Coronary angiography confirmed the presence of a split RCA in both individuals, with variations in bifurcation and vessel size.

Findings:

• In one case, the RCA bifurcated immediately after its origin into two well-developed arteries.
• In the second case, the RCA split from adjacent ostia into two major, nearly equal-sized arteries.
• Both split RCAs exhibited a parallel course, a notable anatomical characteristic.

Implications:

• Split RCA, though rare, can manifest as angina pectoris, necessitating diagnostic investigation.
• Accurate identification via coronary angiography is key for appropriate patient management.
• Medical treatment was initiated for both patients, with favorable short-term outcomes, highlighting the importance of recognizing and managing this anomaly.