Daily Bolus of LR: Anomalous right coronary artery or "malignant" course

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November 7, 2012 by dailybolusoflr

Anomalous right coronary artery or “malignant” course
·         The right coronary artery typically arises from the right sinus of Valsalva and runs between the pulmonary trunk and the right atrium
·         In the “malignant” course (a congenital abnormality), the right coronary artery arises from the left sinus of Valsalva and runs between the pulmonary trunk and the aorta
·         Although a rare finding (less than 0.2% of patients undergoing angiography), the incidence of sudden death in these patients has been estimated at 25-40%, with almost half occurring during exercise
·         Etiology of death is unclear, but compression of the vessel between the aorta and pulmonary artery is suspected
·         Treatment can be aggressive (surgery) or conservative (beta blockers)
·         This finding can be found by ED providers on Coronary CTA and should be recognized as a critical finding
Ref:

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