Single Coronary Artery from Right Sinus of Valsalva: A Single Center Experience of Seven Cases
Kanhai Lalani1, M Sudhakar Rao1, Padmakumar Ramachandran1
1Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
Insights
Single coronary artery (SCA) is a rare heart anomaly. This study presents seven unique SCA cases, highlighting the need for updated classifications due to their complex anatomical variations.
Area of Science:
- Cardiology
- Anatomical Pathology
Background:
- Single coronary artery (SCA) is a rare congenital anomaly with a prevalence of 0.024-0.066%.
- While often benign, SCA can lead to significant cardiovascular complications like myocardial ischemia and arrhythmias.
Observation:
- Seven cases of SCA were analyzed, characterized by the emergence of all three major coronary arteries from the right sinus of Valsalva via a single ostium.
- A minor branch from the left sinus supplied a portion of the myocardium in some cases.
- These specific SCA variations presented unique anatomical features not precisely aligning with current classification systems.
Findings:
- The described SCA variations represent a distinct subset that challenges existing categorization.
- The anatomical complexity suggests a potential need for revising or developing new classification frameworks for SCA.
Implications:
- Enhanced awareness of SCA and its diverse presentations is crucial for clinicians.
- Accurate diagnosis and management of SCA may require updated classification systems and advanced imaging like CT angiography.
Background:
Single coronary artery (SCA) is a rare anomaly with a prevalence of 0.024-0.066%. Some anomalies are merely benign anatomical variants, whereas some can result in myocardial ischemia or life-threatening arrhythmia. Case Presentation. We described seven cases in which all three major coronaries emerged from the right sinus of Valsalva via a single ostium and supplied the vast majority of the myocardium. A smaller branch arising from the left sinus supplied a modest quantity of myocardium in some of those few cases. These SCA variations do not exactly fit into any existing classification. It is unclear whether we need to modify previous classification systems or newer classification systems.
Conclusions:
SCA is divided based on its anomalous course and is usually a benign condition but it may present with cardiovascular complications. Clinicians should be aware of this entity along with the role of CT angiogram in its diagnosis and management.
Related Concept Videos
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
01:10The Arch of Aorta
Encircling the heart, the coronary arteries form a ring-like structure before...
01:11Overview of Systemic Veins
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
01:21Cardiac Catheterization II: Right Heart Catheterization
01:18Physiology of the Heart: The Cardiac Cycle
Diastole: The Relaxation Phase
During diastole, all four heart chambers relax. The atrioventricular (AV) valves open, and the semilunar valves close. This phase sees the lowest chamber pressures, promoting ventricular filling. Venous blood enters the heart through the...
01:15Thoracic Aorta