Anomalous Right Coronary Artery Arising Off the Pulmonary Artery in an Elderly Woman With Palpitations

Anomalous right coronary artery from pulmonary artery is a rare congenital coronary anomaly that can present as a spectrum of disease, however, often is detected incidentally. We report the case of an incidental diagnosis of anomalous right coronary artery from pulmonary artery in an 81-year-old woman who presented with palpitations. Cardiac testing, including echocardiography, cardiac computed tomography, and electrocardiogram stress testing, were crucial in making the diagnosis and in decision making. This case highlights a scenario where conservative management was preferred over surgical repair given the patient's age and asymptomatic course.