Right Coronary Artery: Abnormal Birth and Literature Review

The birth defect of the right coronary artery from the aorta is an anatomical malformation characterized by the abnormal birth of the right coronary artery from the antero-left sinus. It has an abnormal initial path between the aorta and the pulmonary artery and is most often intramural in the aortic wall. It represents 0.1 to 0.3% of the population and exposes to a high risk of sudden death on exertion. The mechanism retained for sudden death is the occurrence of stress myocardial ischemia by compression of the abnormal artery between the two large vessels. The diagnosis can be confirmed by a careful echocardiographic examination. The coronarography confirms the diagnosis. Surgical treatment presents a very low risk and eliminates the risk of stress myocardial ischemia. It therefore appears necessary to look for this anatomical anomaly systematically, at least in all young adults who engage in intense sports activities.