Location and Course
The right coronary artery (a. coronaria dextra) is one of the first branches of the aorta. Its anatomy and course include the following stages:
- Origin: The vessel arises from the aorta at the level of the right aortic sinus (sinus aortae dexter).
- Anterior surface of the heart: The artery descends between the conus arteriosus of the right ventricle and the right auricle (auricula dextra). In its initial segment, it is covered by the right auricle.
- Coronary sulcus: The vessel runs in the coronary sulcus (sulcus coronarius), which lies transversely and serves as the boundary between the right atrium and right ventricle. On the anterior surface, the right coronary artery lies within subepicardial adipose tissue inside the coronary sulcus.
- Transition to the diaphragmatic surface: Upon reaching the right margin of the heart, the artery passes onto the diaphragmatic surface. Here, it lies deep within the coronary sulcus and reaches the posterior interventricular sulcus.
Branches of the Right Coronary Artery
Along its course, the artery gives off several branches to various cardiac structures:
- Right marginal branch (r. marginalis dexter) — runs along the right margin toward the apex of the heart.
- Conus branch (r. coni arteriosi) — directs toward the conus arteriosus.
- Sinuatrial nodal branch (r. nodi sinuatrialis) — located near the region of the right auricle.
- Intermediate atrial branch (r. atrialis intermedius) — extends to the posterior wall of the right atrium and right ventricle.
- Atrioventricular nodal branches (rr. nodi atrioventricularis) — slender branches supplying the atrioventricular node and bundle.
- Posterior interventricular branch (r. interventricularis posterior) — descends in the posterior interventricular sulcus; at approximately the junction of the middle and lower thirds, it dips into the myocardium. It gives off septal interventricular branches (rr. interventriculares septales).
Vascular Territory
The right coronary artery supplies:
- Walls of the pulmonary trunk and aorta.
- Right and left atria.
- Right ventricle.
- Posterior wall of the left ventricle.
- Interatrial septum.
- Posterior portion of the interventricular septum.
The posterior interventricular branch gives off septal interventricular branches and supplies the posterior portion of the interventricular septum, as well as the posterior walls of both ventricles.
Lymphatic Vessels Along the Artery
Lymphatic vessels of the heart are divided into deep and superficial networks. Superficial vessels originate in the capillary networks of the epicardium and accompany the coronary arteries.
The right lymphatic drainage path runs along the right coronary artery. The lymphatic vessels form a trunk that ascends along the anterior wall of the ascending aorta, drains into the node of the ligamentum arteriosum, and subsequently flows into the anterior mediastinal nodes (nodi mediastinales anteriores).
Clinical Significance
Commonly abbreviated as RCA (right coronary artery).
In right-dominant circulation, occlusion of the right coronary artery leads to a posterior wall myocardial infarction. Involvement of the right ventricle may also occur.