CTICasesAnomalous High Origin of the Right Coronary Artery with Incidental Developing Pneumonia
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Imaging findings
Cardiac CT demonstrates an anomalous high origin or high takeoff of the right coronary artery, arising well above the sinotubular junction. The course of the right coronary artery is otherwise normal. Lung windows reveal a localized area of centrilobular nodularity in a tree-in-bud pattern, ground-glass opacities, bronchial wall thickening, and focal mucoid impaction within the right upper lobe and middle lobe.
Key takeaways
A high takeoff of a coronary artery is a congenital anomaly of origin where the vessel arises above the sinotubular junction. Unlike anomalies of course (such as interarterial courses), a high origin alone is benign and typically does not cause myocardial ischemia. Evaluating the lung windows on all cardiac CT scans is essential, as finding incidental pathology like active focal pneumonia can reveal the true cause of a patient's acute chest pain.
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