Unusual trifurcation of a single left coronary artery

Area of Science:

• Cardiology
• Radiology
• Anatomical Pathology

Background:

• Congenital coronary artery anomalies (CCAA) are uncommon findings during cardiac imaging.
• While often benign, certain CCAAs carry risks, including sudden cardiac death.
• Early detection and understanding of anomalous coronary anatomy are crucial for patient management.

Observation:

• A 46-year-old female patient with diabetes and hypertension presented with exertional angina.
• Coronary angiography revealed a rare anomaly: a trifurcation of the single left coronary artery.
• Additionally, the right coronary artery originated anomalously from the left anterior descending artery.

Findings:

• The identified coronary anomaly involved a trifurcation of the left main coronary artery.
• The right coronary artery demonstrated an aberrant origin from the left anterior descending artery.
• No significant stenotic lesions were observed in the coronary arteries.

Implications:

• This case underscores the importance of recognizing unusual coronary artery anatomy, even in the absence of obstructive coronary artery disease.
• Conservative management may be appropriate for certain complex, non-obstructive coronary anomalies.
• Further research into the long-term prognosis and optimal management strategies for such rare CCAAs is warranted.