Single coronary artery: a familial clustering

Area of Science:

• Cardiovascular Medicine
• Congenital Heart Disease
• Medical Genetics

Background:

• Single coronary artery anomaly is a rare congenital condition.
• It can present with varied anatomical configurations and clinical implications.
• Genetic predisposition for coronary artery anomalies is increasingly recognized.

Observation:

• A 59-year-old male presented with chest pain and was diagnosed with a single coronary artery via coronary angiography.
• His 30-year-old daughter, investigated for dilated cardiomyopathy, was also found to have a single coronary artery.
• The father's anomaly involved the right coronary artery originating from the atrioventricular circumflex, while the daughter's had both main coronary arteries arising from the right sinus of Valsalva.

Findings:

• The father exhibited a single coronary artery with the left coronary artery having a normal distribution.
• The daughter presented with a single coronary artery originating from the right sinus of Valsalva, with the left coronary artery traversing anteriorly to the great vessels.
• This familial occurrence highlights a potential genetic component in the etiology of single coronary artery anomalies.

Implications:

• Understanding diverse anatomical variations of single coronary artery is crucial for accurate diagnosis and management.
• The familial incidence suggests the importance of family screening in cases of congenital coronary anomalies.
• Further research into the genetic basis of these anomalies could improve risk stratification and preventative strategies.