Anesthesia Consideration for a Patient With Incidentally Diagnosed Anomalous Origin of Right Coronary Artery Originating From Pulmonary Trunk (ARCAPA): A Case Study

Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly that is usually diagnosed incidentally. Although usually asymptomatic, ARCAPA can lead to myocardial ischemia of the left ventricular wall and/or sudden cardiac arrest. Here, we report the case of a 48-year-old female who presented for recurrent malignant pleural effusion, who was scheduled for a bronchoscopy, thoracoscopic evaluation of left pleural effusion, multiple excisional biopsies of the left chest wall and costophrenic parietal pleural nodules, and insertion of tunneled PleurX™ catheter (Becton, Dickinson and Company, Franklin Lakes, New Jersey, United States). ARCAPA was discovered incidentally in this patient during the preoperative evaluation. The patient was asymptomatic and echocardiogram findings were within normal limits. No additional intervention was required, and the patient was managed satisfactorily with general anesthesia.