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An Uncommon Cause of Angina

David S Majdalany1, Elaina A Blickenstaff2, Francois Marcotte3

  • 1Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Diagnostics (Basel, Switzerland)
|September 13, 2025
PubMed

Insights

Coronary artery anomalies require consideration in young patients with angina. Prompt diagnosis via imaging and surgical re-implantation of the anomalous right coronary artery from the pulmonary artery is crucial.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Coronary artery anomalies are rare but significant causes of angina in young patients.
  • Anomalous origin of the right coronary artery from the pulmonary artery is a rare congenital anomaly.

Purpose of the Study:

  • To highlight the importance of considering coronary anomalies in young patients presenting with angina.
  • To emphasize the role of multi-modality imaging in diagnosing coronary artery anomalies.
  • To present a case of anomalous right coronary artery from the pulmonary artery and its successful surgical management.

Main Methods:

  • Clinical presentation of a young patient with angina.
  • Diagnostic workup including multi-modality imaging (coronary angiography, tomographic imaging).
  • Surgical intervention involving re-implantation of the anomalous right coronary artery.

Main Results:

  • The patient presented with symptoms suggestive of coronary ischemia.
  • Multi-modality imaging confirmed the anomalous origin of the right coronary artery from the pulmonary artery.
  • Successful surgical re-implantation of the anomalous right coronary artery to the aorta was performed.

Conclusions:

  • Coronary artery anomalies should be suspected in young patients with angina.
  • Prompt diagnosis and timely surgical intervention are essential for favorable outcomes.
  • Anomalous right coronary artery from the pulmonary artery requires surgical correction to restore normal coronary blood flow.

Keywords:
anginaanomalous right coronary artery from the pulmonary artery (ARCAPA)chest paincomputed tomographycoronary angiography

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