Intramyocardial and intra-atrial courses in the right coronary artery: prevalence and characteristics

We aimed to determine the prevalence and radiological characteristics of myocardial bridging (MB) and intra-atrial course anomaly (IARCA), which are rare course variations of the right coronary artery (RCA), in the adult patient population.

Radiological images of cases over the age of 18 who underwent coronary CT angiography (CTA) examination in our clinic were scanned from the archives retrospectively, and cases with MB of the RCA and IARCA detection were included in the study. The number, age and gender distribution of the cases, whether there were any other accompanying vascular anomalies, whether there was atherosclerosis in the coronary arteries (calculation of Agatston total calcium score, calculation of atherosclerotic stenosis as a percentage, if any) were evaluated.

The prevalence of MB in the RCA was 2.06%, and the prevalence of IARCA was 0.44%. In one case, both anomalies were detected together. The average MB segment length in RCA was 21.9 mm, and the average IARCA segment length was 37.9 mm. There was no atherosclerotic disease in the RCA segment where anomaly was detected.

Recognition of rare course anomalies of RCA before treatment procedures such as ablation and surgery is important to prevent complications that may have potentially fatal consequences.