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Anomalous Right Coronary Artery With Interarterial Course Presenting As Exercise-Induced Inferior ST-Elevation

Shan Zaidi1, Ashley M Porter2, Satyajeet Roy3

  • 1Department of Cardiology, Cooper Medical School of Rowan University, Camden, USA.

Cureus
|June 29, 2026
PubMed

Insights

An anomalous right coronary artery (ARCA) is a rare congenital condition where the right coronary artery originates abnormally. Early recognition and management are crucial for preventing myocardial ischemia and sudden cardiac death.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Anomalous right coronary artery (ARCA) is a rare congenital anomaly where the RCA arises from an atypical location, often the left sinus of Valsalva or left main coronary artery.
  • This condition can lead to myocardial ischemia, exertional angina, and sudden cardiac death, particularly when the RCA follows an interarterial course.
  • ARCA is frequently associated with a stenotic ostium and an acute origin angle, increasing the risk of compression.

Keywords:
anomalous right coronary arterycoronary artery bypass grafting (cabg)interarterial coursemultimodality imagingst-elevation myocardial infarction

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