Interarterial course of right coronary artery

Case contributed by Yaïr Glick

Presentation

Shortness of breath, suspected pulmonary embolism.

Patient Data

Age: 60 years
Gender: Male

No embolus in main or segmental pulmonary arteries.

Right coronary artery (RCA) has aberrant origin from left coronary sinus and interarterial course between ascending aorta and right ventricular outflow tract (RVOT).
The left main coronary artery trifurcates into the left anterior descending (LAD) artery, left circumflex (LCx) artery and between them - a ramus intermedius artery.

Case Discussion

An interarterial course of an aberrant cardiac artery is potentially dangerous in that the artery could be compressed between the ascending aorta and the pulmonary trunk, leading to ischemia of its territory. This usually happens on exertion, e.g. during exercise. Perhaps a sedentary lifestyle does have its perks.

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