Absence of Right Coronary Ostium with Single Coronary Artery: A Rare Anomaly

Coronary arteries normally originate from two separate cusps from the aorta, and various anomalies can occur. One such anomaly is the single coronary artery (SCA), where the coronary arteries originate from a single ostium due to the absence of the contralateral ostia. In a rare case we encountered while evaluating a patient with atypical chest pain, computed tomography angiography revealed that the right ostia was absent, and the right coronary artery originated from the left circumflex artery. This subtype of SCA has been exceedingly rare, with only a few cases reported in the literature.