Brito, JoanaPlácido, RuiMatos, Pedro2025-02-112025-02-112024Eur Heart J Case Rep. 2023 Dec 26;8(1):ytad642http://hdl.handle.net/10400.5/98332© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.A 48-year-old woman with no relevant past medical history was referred for coronary computed tomography angiography (CCTA) due to complaints of atypical angina lasting for 2 months. The CCTA depicted a coronary calcium score of 0 and no atherosclerotic disease. However, during the assessment of the coronary anatomy, an abnormal right coronary artery (RCA) course was observed (Panels A, B, and C), showing a proximal-to-mid segment with a high trajectory, above the atrioventricular groove (Panels A and B—yellow arrows). This was followed by an intracavitary course. (Panels A and C—red arrows), entering the right atrium (RA) through the lateral wall, and exiting the cavity in the posterior wall, rejoining the right atrioventricular grooveengjournal article10.1093/ehjcr/ytad6422514-2119