Hypoplastic right coronary artery

Case contributed by Dr Abdulmajid Bawazeer

Presentation

The patient came with chest pain when doing hard work.

Patient Data

Age: 30 years
Gender: Female

The right coronary artery appears short and diffusely thin along its course, however, normal in origin.
Left main coronary artery appears normal in large and caliber with no aneurysmal dilatation or stenosis.
Left anterior descending, left circumflex and ramus intermedius are unremarkable.
The left coronary artery gives posterior descending artery.

Case Discussion

Hypoplastic coronary artery disease (HCAD) is a rare condition in which the coronary arteries are abnormally small. Sudden cardiac death (SCD) has been reported as an initial presentation of this condition, and opportunities for treatment are rare 1.
Heart dominance is described by which coronary artery branch gives off the posterior descending artery and supplies the inferior wall, and is characterized as left, right, or codominant. In our case, the left coronary artery is dominant as it gives posterior descending artery 2-4.

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