Anomalous Interarterial Right Coronary Artery: Approach to a High-Risk Course

Area of Science:

• Cardiology
• Congenital Heart Disease
• Cardiac Imaging

Background:

• Congenital coronary artery anomalies are often incidental findings in adults.
• The clinical significance of anomalous coronary arteries depends on their anatomical course.
• An interarterial course is associated with a high risk of sudden cardiac death.

Observation:

• This report details a rare case of anomalous origin of the right coronary artery.
• The patient presented with nonspecific symptoms and no inducible ischemia.
• The anomalous artery followed an interarterial course.

Findings:

• The interarterial course of anomalous coronary arteries is considered malignant.
• Presentation can be variable, even in the absence of ischemic evidence.
• This specific anomaly (anomalous interarterial right coronary artery) is rare.

Implications:

• Risk stratification for sudden cardiac death in such anomalies is challenging.
• Guidelines for physical activity and treatment, including surgical correction, are not well-defined.
• Further data is needed to understand the long-term implications of anomalous interarterial coronary arteries.