Anomalous right coronary artery: a multimodality hunt for the origin

Area of Science:

• Cardiology
• Medical Imaging
• Congenital Anomalies

Background:

• Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital heart defect.
• Early diagnosis is essential for timely intervention and management.

Observation:

• A 48-year-old female presented with angina and exertional shortness of breath, with initial T-wave inversions on ECG.
• Transthoracic echocardiography suggested a coronary-cameral fistula, showing unusual Doppler signals and diastolic flow patterns.

Findings:

• A multimodality imaging approach, integrating cardiac CT and MRI, confirmed the diagnosis of ARCAPA.
• Cardiac CT and MRI demonstrated high accuracy in delineating the anomalous coronary artery anatomy.

Implications:

• This case underscores the diagnostic challenges of ARCAPA.
• Multimodality imaging, particularly CT and MRI, plays a vital role in confirming ARCAPA and guiding surgical correction.