Key result
Conservative management maintains asymptomatic status in a patient with congenital RCA absence and corrected CHD.
Case Report (n=1)
This case highlights the rare occurrence of congenital absence of the right coronary artery in a patient with corrected congenital heart disease, which can be managed conservatively in the absence of ischemia.
Conservative management may suffice for asymptomatic congenital RCA absence; leaves open questions on screening and prognosis in corrected congenital heart disease.
Congenital absence of the right coronary artery (RCA) is an extremely rare coronary anomaly that may occur in isolation or in association with other congenital heart defects. We report the case of a woman in her early 30s with a history of surgically corrected congenital heart disease, who was diagnosed with RCA agenesis during evaluation for mild anginal symptoms. Coronary CT angiography revealed the absence of the RCA origin, which was confirmed by coronary angiography. No obstructive coronary lesions were identified. Given her stable condition and absence of myocardial ischaemia, a conservative approach was chosen. The patient remained asymptomatic on follow-up. This case underscores the importance of recognising coronary anomalies in young patients with chest pain, as accurate diagnosis can guide appropriate management and prevent potential complications.
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Gutemberg et al. (2025) conducted a case report in Congenital absence of the right coronary artery (n=1). Conservative management was evaluated. A woman in her early 30s with surgically corrected congenital heart disease was diagnosed with congenital absence of the right coronary artery and remained asymptomatic on conservative management.
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