Feature image

Tubular origin of RCA (high take off)

Case courtesy of Brian Gilcrease-Garcia, Radiopaedia.org. From the case rID: 59707

Origin

Atresia

• Most common = LMCA → get collateral from large conus branch (from RCA)

High take off

• > 1 cm above sinotubular junction
• Most common = RCA
• associated with bicuspid aortic valve

Multiple ostia

Single coronary artery

↑ mortality in case of

• Interarterial course
• Proximal stenosis

Origin from PA

ALPACA = LMCA arising from PA → coronary steal phenomenon (retrograde flow from collateral to LMCA → PA)

Course

Myocardial bridging

• Most common = middle LAD

Need both systolic and diastolic phases imaging to evaluate degree of luminal narrowing.

Duplicate LAD

Termination

Coronary artery fistula

Most common = RCA → draining to RV (45%), RA, PA, LA

Coronary arcade