Corpus: Right coronary artery

The arteria coronaria dextra, or ACD for short, is a coronary artery that arises from the ascending branch of the aorta, more precisely from the sinus aortae dexter, directly behind the aortic valve.

The arteria coronaria dextra runs between the conus arteriosus and the right auricle to the right section of the coronary sulcus. It follows this and then reaches the facies diaphragmatica of the dorsal surface of the heart. There it gives off its final branch, the posterior interventricular ramus (RIVP, RPD, R-PDA) at the crux cordis (CC), which runs in the posterior interventricular sulcus towards the apex of the heart and anastomoses with the anterior interventricular ramus of the left coronary artery.

The branching of the arteria coronaria dextra varies greatly between individuals, so that the branches listed here serve only as a guide.

• Rami coni arteriosi (RCO): to the conus arteriosus and parts of the anterior wall of the right ventricle
• Ramus nodi sinuatrialis (RNS): to the sinus node
• Rami atrioventriculares dextri (RAVD): to the front of the right atrium and right ventricle
• Rami atriales dextri (RAD): to lateral sections of the right atrium
• Ramus marginalis dexter (RMD): to the lateral side of the right ventricle
• Ramus posterolateralis dexter (RPLD): to the back of the right ventricle
• Ramus nodi atrioventricularis: to the AV node
• Ramus interventricularis posterior (RIVP, ramus descendens posterior): between the two ventricles
  • Rami interventriculares septales (RSP, Rami septales posteriores): for the posterior third of the ventricular septum

The supply area of the right coronary artery includes the right atrium and the right ventricle as well as parts of the posterior wall of the left ventricle, including the wall near the posterior interventricular sulcus and the posterior section of the ventricular septum.

The arteria coronaria dextra also supplies the sinus node, the AV node and other parts of the conduction system (e.g. His bundle).

If the proximal RCA is occluded, an inferior posterior wall infarction occurs, provided there is a normal supply type. Direct signs of infarction are seen on the ECG in leads II, III, aVF and V6, indirect signs of infarction in V1 to V4, I and aVL.

In 20 % of cases, there is also an infarction of the right ventricle. This leads to further direct signs of infarction in V1 and the right precordial leads V3r to V6r.

If only the posterior interventricular ramus is affected, this is referred to as a posterior posterior wall infarction. Only indirect signs of infarction in V1 to V4 are recognisable on the ECG. Direct signs of infarction can only be detected in the extended left precordial leads V7 to V9.