title: Anomalous right coronary artery: a case report.
abstract: BACKGROUND
  Anomalous coronary arteries (ACAs) are rare but potentially life-threatening abnormalities of coronary circulation. Most variations are benign; however, some may lead to myocardial ischemia and/or sudden cardiac arrest.
  
  
  METHODS
  We present the case of a patient with a significant medical history of hypertension, hyperlipidemia, type 2 diabetes, obesity, and gastroesophageal reflux disease who presented to the emergency department with atypical chest pain. She underwent a cardiac catheterization that showed an anomalous right coronary artery originating near the anterior left coronary artery sinus and coursing between the pulmonary artery and aorta. The patient was deemed a poor surgical candidate, was discharged home on medical management with beta blocker therapy, and was instructed to restrict her physical activity.
  
  
  CONCLUSIONS
  Treatment of significant anomalies should be guided by the nature of the anomalous vessel. Symptomatic patients with ACAs have 3 treatment options: medical management, coronary angioplasty and stent deployment, or surgical correction. These treatment options remain controversial. Some clinicians advocate revascularization, but the long-term benefits of revascularization therapies have not yet been demonstrated.
authors.affiliation: John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Amit N
authors.initials: AN
authors.lastname: Keswani
authors.affiliation: John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Dann
authors.affiliation: John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ramee
keywords: Coronary artery disease; coronary circulation