Intra-atrial course of the right coronary artery

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Chest pain ?CAD.

Patient Data

Age: 50 years
Gender: Male

LMCA, LAD, circumflex and RCA are of normal caliber and free of atherosclerotic disease.

The mid RCA takes an intra-atrial course, lying within the lumen of the lower right atrium.

No pulmonary parenchymal, pleural or other abnormality identified in the portion of the thorax imaged.

Case Discussion

In this uncommon anatomic variation of the course of the RCA, the mid and distal segments course through the atrial chamber. The clinical consequence is minimal except during any procedure where a wire is passed into or through the right atrium, which may injure the RCA.

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