Intra-atrial Course of the Right Coronary Artery: A Report of a Rare Case

Coronary artery anomalies (CAAs) are congenital variations involving the origin, course, or termination of coronary arteries. Among these, an intra-atrial course of the right coronary artery (RCA) is a rare anatomical variant with significant clinical implications, particularly during interventional or surgical procedures. We report the case of a 69-year-old man who presented with chest discomfort and was diagnosed with an intra-atrial RCA using multi-detector computed tomography angiography (MDCTA). Although typically asymptomatic, this anomaly warrants recognition to avoid inadvertent injury during cardiac interventions such as catheterization, pacemaker implantation, or surgery. MDCTA revealed no significant coronary artery stenosis, and the patient was managed conservatively without invasive coronary angiography.