Anesthetic Challenges in Interarterial Right Coronary Artery Anomaly from the Left Sinus of Valsalva: A Case Report.

Coronary artery anomalies are rare but clinically significant malformations, particularly when involving an interarterial course, which predisposes to ischemia and sudden cardiac death. We report the case of a previously healthy 22-year-old man who suffered out-of-hospital cardiac arrest associated with recreational inhalant use. Imaging revealed an anomalous right coronary artery originating from the left sinus of Valsalva with interarterial trajectory. Surgical reimplantation was performed under tailored anesthetic management emphasizing hemodynamic stability. The patient recovered uneventfully. This case discusses and highlights anesthetic priorities and the potential role of external triggers in vulnerable coronary anatomy.