Anomalous origin of the right coronary artery from the pulmonary artery diagnosed in an adult: A case report

Anomalous origin of the right coronary artery (ARCA) from the main pulmonary artery is a rare congenital anomaly, unlike the well-known anomalous origin of the left coronary artery (Bland–White–Garland syndrome) from the pulmonary artery. Since most ARCA cases are diagnosed during childhood, few adult cases have been reported. We describe the case of a patient who demonstrated ventricular arrhythmia and low cardiac function due to ischemic heart disease and an ARCA. Coronary angiography revealed flow from the left coronary artery to the pulmonary artery via an epicardial collateral artery and the right coronary artery. Multidetector-row computed tomography provided a definitive diagnosis of ARCA; the patient underwent surgical revascularization. Learning objective: We incidentally diagnosed ARCA in a patient who experienced ventricular fibrillation. ARCA is a rare condition caused by early-onset cardiac ischemia, which may be a differential diagnosis for this congenital anomaly. Multidetector-row computed tomography is useful for detecting ARCA and determining the coronary artery's course and other congenital anomalies. Immediate surgical treatment for ARCA is strongly recommended to prevent sudden cardiac death.>