Simultaneous occurrence of a single coronary artery and persistent left superior vena cava
Emily Hass1, Ammar Shreef, Joseph M Bumgarner
1Division of Cardiology, University of North Carolina, Chapel Hill, USA.
Insights
This case report details a 57-year-old woman with simultaneous rare congenital anomalies: a single coronary artery and persistent left superior vena cava. Such a dual occurrence is exceptionally rare, estimated at 1 in 10 million.
Area of Science:
- Cardiology
- Congenital Anomalies
- Vascular Biology
Background:
- Congenital heart disease and vascular anomalies represent significant clinical challenges.
- Single coronary artery (SCA) and persistent left superior vena cava (PLSVC) are individually rare but recognized conditions.
- Understanding their co-occurrence is crucial for comprehensive patient management.
Observation:
- A 57-year-old female presented with dyspnea.
- Diagnostic workup revealed the simultaneous presence of a single coronary artery and a persistent left superior vena cava.
- This represents an extremely rare combination of congenital cardiovascular anomalies.
Findings:
- The incidence of SCA is estimated at 0.024%–0.066% in the general population.
- PLSVC occurs in 0.3% of individuals without other anomalies, rising to 5% with co-existing anomalies.
- The probability of this specific dual anomaly occurring randomly is approximately 1 in 10 million.
Implications:
- Simultaneous rare anomalies necessitate thorough diagnostic evaluation and tailored clinical strategies.
- Recognition of these anomalies is vital for preventing potential complications and guiding treatment.
- This case highlights the importance of considering rare congenital conditions in clinical practice.
Abstract:
We present a case of simultaneous occurrence of 2 rare congenital anomalies. A 57-year-old woman undergoing evaluation of dyspnea was found to have a single coronary artery and persistent left superior vena cava. The incidence of single coronary artery is 0.024% to 0.066% in the general population. Persistent left superior vena cava occurs in 0.3% of those without other congenital anomalies and in up to 5% when other anomalies are present. The likelihood of both anomalies occurring as a random event in 1 patient is approximately 1 in 10 million. Patient characteristics and data are presented, with a discussion on the epidemiology, incidence, diagnosis and pathologic implications of each anomaly.
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