Abstract
Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is an extremely rare congenital coronary artery anomaly. Diagnosis is often made incidentally when evaluating for a murmur or other congenital heart disease. The ARCAPA may present with right heart failure and/or sudden cardiac death and surgical repair is recommended once the diagnosis is made.
A seven-year-old child previously diagnosed with small ventricular septal defects presented to our cardiology clinic as a new patient. Echocardiogram revealed suspicion of a coronary anomaly and computed tomography angiography (CTA) confirmed a diagnosis of ARCAPA. She underwent successful surgical reimplantation of the anomalous right coronary artery and made an excellent recovery.
This case highlights the importance of maintaining a high index of suspicion for coronary anomalies and strongly considering CTA in patients with imaging findings or symptoms consistent with ARCAPA.
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