Absent Right Coronary Artery in an Active Young Female

JB is a 22-year-old white female with a history of back pain and 2 microdiscectomies who was a 3-sport athlete in high school and played Division III softball during college. Since graduating college, she has been working as an inpatient nurse. In April 2020, her nursing unit was transitioned to care for COVID-19 patients. Approximately two months later, in June 2020, JB noted her exercise tolerance had declined to a level far below what she had been able to achieve just a few months prior. During that time, her running pace and distance had gradually decreased due to fatigue and occasional chest discomfort. Later that year, she began experiencing sensations of her heart “beating really hard” during aerobic exercise training. She noted heart rates (HRs) of 190 to 200 b·min⁻¹ on several different occasions. These HRs were alarming to her because just 10 months earlier she had been running...