The Single Coronary Artery: A Rare Anatomic Variant
Kendi Burnette-Phelps1,2, Lydia S Sohn1,2, Anjali Bhardwaj3
1Des Moines University, Des Moines, Iowa, US.
Methodist Debakey Cardiovascular Journal
|August 18, 2025
Insights
A rare coronary artery anomaly was found in a heart failure patient where all major vessels originated from one opening in the aorta. This single ostium presentation is a significant finding for cardiovascular diagnosis.
Area of Science:
- Cardiology
- Anatomical Variations
Background:
- Congenital coronary artery anomalies can predispose individuals to myocardial ischemia and sudden cardiac death.
- A single coronary ostium is a rare anomaly with varying clinical presentations.
Purpose of the Study:
- To describe a unique case of a single coronary ostium in a patient with heart failure.
- To highlight the importance of detailed coronary angiography in diagnosing complex congenital heart disease.
Main Methods:
- Coronary angiography was performed to visualize the coronary artery anatomy.
- Echocardiography was used to assess left ventricular function and ejection fraction.
Main Results:
- The patient presented with heart failure and a reduced ejection fraction of 25%.
- Angiography demonstrated all major coronary arteries arising from a single ostium in the right aortic sinus.
Conclusions:
- A single coronary ostium originating from the right aortic sinus can be associated with significant cardiac dysfunction.
- Accurate identification of coronary artery anomalies is crucial for appropriate patient management and risk stratification.
Abstract:
We report the case of a 67-year-old female with heart failure and a reduced ejection fraction (25%). Angiography revealed that all of her major coronary vessels stemmed from a single ostium at the right aortic sinus.
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