A Rare Case of Isolated Single Coronary Artery, Lipton's Type R-IIB in an Elderly Woman With Recurrent Chest Pain and
Olurotimi J Badero1,2, Pelumi Ajayi3, Osibowale Bamikole4
1Department of Cardiology, Lagos University Teaching Hospital, Lagos, Nigeria.
Insights
Single coronary artery (SCA) is a rare congenital heart defect. This case highlights an elderly woman with chest pain, emphasizing the importance of diagnosing SCA, especially with high-risk inter-arterial courses.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Medical Imaging
Background:
- Single coronary artery (SCA) is a rare congenital anomaly.
- SCA can be asymptomatic or lead to serious cardiac events like sudden cardiac death (SCD).
- Inter-arterial courses of SCA increase the risk of malignant arrhythmias.
Abstract:
Single coronary artery (SCA) is a rare congenital coronary anomaly arising from a solitary ostium, supplying the entire myocardium. Often asymptomatic and incidental, those with inter-arterial courses carry an increased risk of arrhythmia or sudden cardiac death (SCD). We report a case of SCA in an elderly woman with recurrent chest pain and left bundle branch block (LBBB). Angiogram revealed an anomalous Lipton type R-IIb SCA arising from the right coronary sinus with a malignant inter-arterial course confirmed by coronary CTA. She was referred for surgery due to the risk of SCD and malignant arrhythmia. SCA represents a rare but clinically significant coronary anomaly, particularly those with a malignant course. Early recognition and detailed anatomical characterization using noninvasive and invasive imaging techniques are crucial for accurate diagnosis and risk assessment.
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