Single coronary artery anomaly: a report of three cases

Area of Science:

• Cardiology
• Congenital Heart Disease
• Diagnostic Imaging

Background:

• Congenital coronary artery anomalies are rare but can lead to significant cardiovascular events.
• A single coronary artery is a rare anomaly where the entire heart is supplied by one vessel.
• Incidental detection during routine procedures necessitates understanding of varied presentations.

Purpose of the Study:

• To present three distinct cases of anomalous single coronary artery.
• To illustrate the diagnostic approach and clinical implications of this anomaly.
• To discuss management strategies based on anatomical variations and patient symptoms.

Main Methods:

• Retrospective case series.
• Review of coronary angiography findings.
• Clinical correlation of symptoms and outcomes.

Main Results:

• Three patients with anomalous single coronary artery were identified during routine coronary angiography.
• Case 1: Type L-I anomaly with non-cardiac chest pain, resolved without intervention.
• Case 2: Type R-I anomaly with significant stenosis, successfully treated with bypass surgery.
• Case 3: Type R-II-B anomaly with high-risk anatomical course, surgery recommended but refused.

Conclusions:

• Anomalous single coronary artery can present with diverse clinical scenarios, from asymptomatic to requiring surgical intervention.
• Coronary angiography is crucial for diagnosing and characterizing single coronary artery anomalies.
• Management should be individualized based on the specific anomaly, associated pathologies, and patient presentation.