Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2022; 14(9): 514-521
Published online Sep 26, 2022. doi: 10.4330/wjc.v14.i9.514
Intra-atrial course of right coronary artery: A case report
Giulio Barbiero, Giuseppe Maiolino, Anna Argiolas, Luca Testolin, Giorgio De Conti
Giulio Barbiero, Anna Argiolas, Giorgio De Conti, Department of Integrated Diagnostic Services, DIDAS, Radiology Unit, University Hospital of Padua, Padua 35128, Italy
Giuseppe Maiolino, Department of Medicine, Medical Clinic 3, University Hospital of Padua, Padua 35128, Italy
Luca Testolin, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Cardiac Surgery, University Hospital of Padua, Padua 35128, Italy
Author contributions: All authors contributed to the study conception and design; Barbiero G, Argiolas A, and Maiolino G performed the patient exam; Barbiero G performed the literature review and wrote the first draft of the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giulio Barbiero, MD, Doctor, Department of Integrated Diagnostic Services, DIDAS, Radiology Unit, University Hospital of Padua, Via Giustiniani 2, Padua 35128, Italy. giulio.barbiero@aopd.veneto.it
Received: July 16, 2022
Peer-review started: July 16, 2022
First decision: August 4, 2022
Revised: August 11, 2022
Accepted: August 30, 2022
Article in press: August 30, 2022
Published online: September 26, 2022
Processing time: 65 Days and 6.8 Hours
Abstract
BACKGROUND

Intra-atrial right coronary artery (RCA) is a rare and generally asymptomatic anomaly of development of the coronary arteries. This malformation could potentially expose the patient to a catastrophic outcome in the case of injury during interventional or surgical procedures. Currently, only a few case reports and no systematic reviews are available in the literature.

CASE SUMMARY

We report the case of a 54-year-old man with atypical chest pain who underwent multi-detector computed tomography angiography (MDCTA). The exam revealed no significant coronary artery stenoses; however, an intra-atrial course of mid RCA was evident. Medical therapy was administered, and the patient was discharged to home without undergoing a conventional angiography. Previously reported autoptic and clinical cases were retrieved from the PubMed literature database to compare the clinicopathological features of this case.

CONCLUSION

MDCTA depicted the abnormal course of the coronary artery in this patient as an intra-atrial course of the mid RCA. Finding this abnormality was crucial to avoid an inadvertent injury during interventional or surgical procedures.

Keywords: Coronary artery anomaly; Anomalous course of right coronary artery; Intra-atrial right coronary artery; Intracavitary right coronary artery; Multi-detector computed tomography angiography; Case report

Core Tip: We present a rare case of an intra-atrial course of the mid right coronary artery (commonly referred to as right coronary artery) detected by multi-detector computed tomography angiography (MDCTA). We performed a systematic review of the few cases in the literature. Since this anomaly could potentially expose the patient to catastrophic outcome in case of injury during interventional or surgical procedures, its recognition via MDCTA is crucial before such interventions.