One Ostium to Rule Them All: Rare Case of a Single Coronary Artery

Area of Science:

• Cardiology
• Congenital Heart Disease
• Medical Imaging

Background:

• A single coronary artery is a rare congenital anomaly affecting 0.024% of the population.
• Symptoms range from asymptomatic to severe angina and sudden cardiac arrest.
• Understanding the coronary artery's origin and course is crucial for patient management.

Purpose of the Study:

• To highlight the diagnostic utility of cardiac computed tomography angiography (CCTA) in a case of single coronary artery.
• To discuss the clinical implications and management of this congenital anomaly.
• To emphasize the importance of risk stratification in patients with single coronary artery.

Main Methods:

• Case report of a patient diagnosed with a single coronary artery.
• Utilized cardiac computed tomography angiography (CCTA) to visualize the anomalous coronary artery's origin and course.
• Reviewed literature on single coronary artery anomalies and their management.

Main Results:

• CCTA confirmed an anomalous common origin anterior to the sinus of Valsalva with a prepulmonic course.
• The prepulmonic course was associated with a benign prognosis, leading to conservative management.
• Coronary angiography remains the gold standard for ischemic work-up.

Conclusions:

• CCTA is an essential tool for defining the course of anomalous coronary arteries.
• Risk stratification using CCTA aids in appropriate patient management.
• Conservative management may be suitable for single coronary artery anomalies with a benign course.