{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:33:01Z","timestamp":1783636381998,"version":"3.55.0"},"reference-count":12,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly, with an uncertain prevalence and often diagnosed incidentally. This case report presents a 62-year-old male with ARCAPA diagnosed during an evaluation for chest surgery. The patient had a history of colon cancer and active tuberculosis, complicating the clinical management. He reported chest pain, shortness of breath, and palpitations, with atrial fibrillation observed on a 24 h Holter ECG. Coronary angiography revealed robust collateral circulation and a suspected anomalous origin of the right coronary artery, confirmed by CT imaging. The patient\u2019s stress MRI showed mildly reduced left and right ventricular ejection fractions and perfusion deficits in the apical segments (2\/17) of the septal and inferior walls. Given the patient\u2019s comorbidities, including active tuberculosis, the Heart team decided on a non-operative management approach, focusing on careful monitoring and pharmacological management rather than immediate surgery. This case emphasizes the complexity of managing ARCAPA in the context of significant comorbidities, highlighting the importance of individualized, multidisciplinary treatment strategies. Early diagnosis using advanced imaging techniques is crucial, and a non-operative approach can be considered in patients with preserved left ventricular function and no significant ischemia, as demonstrated in this case.<\/jats:p>","DOI":"10.3390\/life15050736","type":"journal-article","created":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:42:37Z","timestamp":1746391357000},"page":"736","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anomalous Right Coronary Artery in the Setting of Active Tuberculosis: A Multidisciplinary Management Challenge"],"prefix":"10.3390","volume":"15","author":[{"given":"Ana","family":"Peruni\u010di\u0107","sequence":"first","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matija","family":"Furtula","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Veljkovi\u0107","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5623-7678","authenticated-orcid":false,"given":"Jovana","family":"Lak\u010devi\u0107","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2865-0446","authenticated-orcid":false,"given":"Armin","family":"\u0160ljivo","sequence":"additional","affiliation":[{"name":"Department for Cardiosurgery, Clinical Center of University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Balint","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slobodan","family":"Tomi\u0107","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Vu\u010dini\u0107","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milovan","family":"Boji\u0107","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2724-2854","authenticated-orcid":false,"given":"Aleksandra","family":"Nikoli\u0107","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute \u201cDedinje\u2019\u2019, 11040 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s10396-019-00933-7","article-title":"Diagnosis of anomalous origin of the right coronary artery from the pulmonary artery by echocardi-ography","volume":"46","author":"Wu","year":"2019","journal-title":"J. Med. Ultrason."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jccase.2020.05.005","article-title":"Successful off-pump reimplantation of the anomalous right coronary artery from the pulmonary artery: A case report","volume":"22","author":"Nishijima","year":"2020","journal-title":"J. Cardiol. Cases"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.athoracsur.2020.01.082","article-title":"Anomalous origin of the right coronary artery from the pulmonary artery: A systematic review","volume":"110","author":"Guenther","year":"2020","journal-title":"Ann. Thorac. Surg."},{"key":"ref_4","first-page":"2583918","article-title":"Anomalous Origin of a Right Coronary Artery from Pulmonary Artery","volume":"2018","author":"Rawala","year":"2018","journal-title":"Case Rep. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Marcu, D.T., Adam, C.A., Mitu, F., Cumpat, C., Aursulesei Onofrei, V., Zabara, M.L., Burlacu, A., and Crisan Dabija, R. (2023). Cardiovascular Involvement in Tubreculosis: From Pathophysiology to Diagnosis and Complications-A Narrative Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13030432"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"170012","DOI":"10.1183\/16000617.0012-2017","article-title":"Differential diagnosis of granulomatous lung disease: Clues and pitfalls","volume":"26","author":"Ohshimo","year":"2017","journal-title":"Eur. Respir. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"ytad113","DOI":"10.1093\/ehjcr\/ytad113","article-title":"Anomalous origin of the right coronary artery from pulmonary artery in an adult presenting with rapid atrial fibrillation: A case report","volume":"7","author":"Kofoed","year":"2023","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.xjtc.2022.07.023","article-title":"Anomalous right coronary artery from the pulmonary artery: An institutional report","volume":"15","author":"Policarpio","year":"2022","journal-title":"JTCVS"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"23247096241269935","DOI":"10.1177\/23247096241269935","article-title":"Anomalous Right Coronary Artery From Pulmonary Artery Presenting as Inferior Wall Ischemia: A Case Report","volume":"12","author":"Rawlley","year":"2024","journal-title":"J. Investig. Med. High. Imopact Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"ESC guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/clc.20848","article-title":"Anomalous origin of the left coronary artery from the pulmonary artery in adults: A comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman","volume":"34","author":"Yau","year":"2011","journal-title":"Clin. Cardiol."},{"key":"ref_12","first-page":"769","article-title":"2018 AHA\/ACC guideline for the management of adults with congenital heart disease: A report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines","volume":"139","author":"Stout","year":"2019","journal-title":"Circulation"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/5\/736\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:25:57Z","timestamp":1760030757000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/5\/736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,1]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["life15050736"],"URL":"https:\/\/doi.org\/10.3390\/life15050736","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,1]]}}}