Event Title

Single coronary artery

Location

Auditorium Pond Side

Start Date

26-2-2014 10:30 AM

Abstract

Introduction: Single coronary artery (SCA) is a rare congenital anomaly of the coronary arteries where only one coronary artery arises from the aortic trunk by a single coronary ostium supplying the entire heart. SCA arising from the right coronary cusp is exceedingly rare. The incidence is 0.03–0.9%. The use of computed tomographic coronary angiography (CTA) for the identification of such coronary artery anomalies is well established. Clinical relevance is mainly dependent on the origin and course of the coronary artery which can vary between asymptomatic to sudden cardiac death. Patients with coronary artery originating from the opposite sinus with proximal vessel segment localized between the pulmonary trunk and the aorta can present with syncope and sudden cardiac death. We found a case with SCA arising from the right coronary cusp on CTA.

Case Report: A 33-year old female with history of coronary artery fistula closure at 10 years of age, presented with chest pain on exertion. There was no family history of ischemic heart disease. Physical examination was normal. There were no ischemic changes on ECG. Laboratory investigations were normal. Patient underwent CTA which showed a SCA with right dominance. Both right and left coronary arteries had a common wide origin from the right coronary cusp. The left coronary artery after originating from the right coronary cusp run anteriorly over the right ventricular outflow tract towards the anterior interventricular groove. It had a short course in the anterior interventricular groove and after giving the LAD branch it turned upward and laterally to take the course of circumflex artery. Right coronary artery had a normal course. There was no significant disease in any of the vessel.

Discussion: This case demonstrates the importance of coronary CTA for unambiguous delineation of both origin and vessel course in patients with very rare coronary anomalies.

Keywords: Single coronary artery, CT angiography

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Feb 26th, 10:30 AM

Single coronary artery

Auditorium Pond Side

Introduction: Single coronary artery (SCA) is a rare congenital anomaly of the coronary arteries where only one coronary artery arises from the aortic trunk by a single coronary ostium supplying the entire heart. SCA arising from the right coronary cusp is exceedingly rare. The incidence is 0.03–0.9%. The use of computed tomographic coronary angiography (CTA) for the identification of such coronary artery anomalies is well established. Clinical relevance is mainly dependent on the origin and course of the coronary artery which can vary between asymptomatic to sudden cardiac death. Patients with coronary artery originating from the opposite sinus with proximal vessel segment localized between the pulmonary trunk and the aorta can present with syncope and sudden cardiac death. We found a case with SCA arising from the right coronary cusp on CTA.

Case Report: A 33-year old female with history of coronary artery fistula closure at 10 years of age, presented with chest pain on exertion. There was no family history of ischemic heart disease. Physical examination was normal. There were no ischemic changes on ECG. Laboratory investigations were normal. Patient underwent CTA which showed a SCA with right dominance. Both right and left coronary arteries had a common wide origin from the right coronary cusp. The left coronary artery after originating from the right coronary cusp run anteriorly over the right ventricular outflow tract towards the anterior interventricular groove. It had a short course in the anterior interventricular groove and after giving the LAD branch it turned upward and laterally to take the course of circumflex artery. Right coronary artery had a normal course. There was no significant disease in any of the vessel.

Discussion: This case demonstrates the importance of coronary CTA for unambiguous delineation of both origin and vessel course in patients with very rare coronary anomalies.

Keywords: Single coronary artery, CT angiography