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Right coronary artery

Dr Craig Hacking ◉ ◈ and Dr Mohammed Izhar et al.

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

On this page:

Article:

Gross anatomy
Coronary dominance
Variant anatomy
See also
Related articles
References

Images:

Cases and figures

Gross anatomy

Origin

It is a branch of the ascending aorta, with its normal origin in the right aortic sinus, just superior to the aortic valve

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%)
sinoatrial nodal artery (60%)
acute marginal arteries (designated AM1, 2, etc)
atrioventicular nodal artery
terminal branches (in right dominant circulation)
- inferior interventricular artery also known as the posterior descending artery (PDA)
- posterior left ventricular branch (PLV, PLB or PLA)
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: atrioventricular (AV) 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

Coronary dominance

Most hearts are right dominant where the PDA is supplied by the RCA. However up to 20% of hearts may be left dominant, where the PDA is supplied by the LAD or LCx or codominant, where a single or duplicated PDA is supplied by branches of both the RCA and LAD/LCx.

For a more in depth discussion of coronary dominance, see the article coronary arterial dominance.

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)
Kugel's artery
- uncommon proximal branch which communicates with either the left circumflex artery or the distal right coronary artery near the crux

Variations in course

intra-atrial course (case 1)
inter-arterial course due to aberrant origin (case 2)
shepherd’s crook right coronary artery

See also

congenital coronary artery anomalies

References

Anatomy: Thoracic

thoracic skeleton
- thoracic cage
  - ribs
    - typical ribs
    - atypical ribs
    - variant anatomy
      - bifid ribs
      - Srb anomaly
  - costal cartilage
  - sternum
- thoracic spine
- articulations
muscles of the thorax
spaces of the thorax
thoracic viscera
blood supply of the thorax
- arteries
  - thoracic aorta (development)
  - pulmonary trunk
    - left pulmonary artery
      - aberrant left pulmonary artery
    - right pulmonary artery
- veins
  - superior vena cava (cavoatrial junction)
  - inferior vena cava
  - coronary veins
    - cardiac veins which drain into the coronary sinus
      - great cardiac vein
      - middle cardiac vein
      - small cardiac vein
      - posterior vein of the left ventricle
      - vein of Marshall (oblique vein of the left atrium)
    - anterior cardiac veins
    - venae cordis minimae (smallest cardiac veins or thebesian veins)
  - pulmonary veins
    - bronchial veins
lymphatics
innervation of the thorax

Article information

rID: 8864

System: Vascular, Cardiac

Section: Anatomy

Tag: heart, cardiology, cardiac, cardiac ct, anatomy, cases, cases

Synonyms or Alternate Spellings:

Right coronal artery (RCA)
Right coronary artery (RCA)
RCA

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Cases and figures

Case 1: intra-atrial course of RCACase 1: intra-atrial course of RCA

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Case 2: inter-arterial course of the RCACase 2: inter-arterial course of the RCA

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