Revision 31 for 'Right coronary artery'

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Right coronary artery

The right coronary artery (RCA) is one of the two main coronary arteries that supply the heart with oxygenated blood.

Gross anatomy

Origin

The RCA arises from the right coronary sinus as one of only two branches of the ascending aorta.

Course

The RCA courses to the right in the right atrioventricular groove, along the anterior surface to the inferior surface of the heart.

  • in people with right dominant circulation (seen in the majority of people), the RCA turns anteriorly at the crus to become the inferior interventricular artery
  • in people with left dominant circulation the RCA peters out usually as an acute marginal artery and the inferior interventricular artery usually arises from the left circumflex artery
Branches
  • conus artery (in 60%)
  • sinus artery (60%)
  • acute marginal arteries (designated AM1, 2, etc)
  • atrioventicular nodal artery
  • terminal branches (in right dominant circulation)
  • In left dominant hearts, the RCA usually peters out as an acute marginal branch
Supply
  • conus artery: pulmonary outflow tract
  • sinus artery: sinoatrial (SA) node
  • acute marginal arteries: anterior wall of the right ventricle
  • atrioventricular nodal artery: atrioventicular (SA) node
  • terminal branches (in right dominant circulation)
    • PDA: inferior wall of the right ventricle and the inferior 1/3 of the interventricular septum (the latter defining coronary dominance)
    • PLV: inferior wall of the left ventricle

Variant anatomy

Variations in origin

  • from the aorta at or above the sinotubular junction
  • from the left coronary sinus or left coronary artery where the proximal RCA takes a 'malignant' inter-arterial course in which the vessel is prone to extrinsic compression
  • in up to 50% of cases there are separate ostia for the RCA and conus artery 2 from the sinus or aorta

Variations in branching

  • PDA and PLV as terminal branches
  • PDA as the only terminal branch (in which the PLV is supplied by the LCx)
  • terminates as an acute marginal branch (in left dominant circulations)

Variations in course

See also

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