Shepherd's crook right coronary artery

Case contributed by Dr Kamel Mahmoud Alkhateeb

Presentation

Chest pain

Patient Data

Age: 70 years
Gender: Male

Kinking in the proximal part of the right coronary artery is seen with stenosis of its lumen.

Case Discussion

A Shepherd's Crook right coronary artery is characterized by a tortuous and high course usually just after its origin from the aorta. It often does not carry clinical significance but complicates the coronary intervention. In some cases, it is associated with obstructive coronary artery disease (CAD) as noted in our case. The clinical importance of coronary tortuosity is still unclear. It is hypothesized that coronary tortuosity leads to flow alteration resulting in a reduction in coronary pressure distal to the tortuous segment of the coronary artery, subsequently leading to ischemia.

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