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Single coronary artery with the right coronary artery arising from the first septal perforator
Insights
A rare single left coronary artery variant was identified in a patient with chest pain. The right coronary artery originated unusually, potentially causing the observed cardiac ischemia.
Area of Science:
- Cardiovascular medicine
- Anatomical variations
- Diagnostic imaging
Background:
- Coronary artery anomalies are rare but can lead to significant cardiac events.
- Accurate diagnosis is crucial for appropriate patient management.
Observation:
- A 50-year-old woman presented with chest pain and evidence of focal ischemia on exercise thallium-201 scintigraphy.
- Coronary arteriography revealed an unreported variant of a single left coronary artery.
Findings:
- The right coronary artery originated as a branch from the first septal perforator, coursing through the ventricular septum.
- The absence of a conus artery was noted, potentially explaining the basal ventricular ischemia and symptoms.
Implications:
- This case highlights the importance of recognizing rare coronary artery anomalies.
- Understanding such variations is key to diagnosing and managing myocardial ischemia.
Abstract:
A 50-year-old woman with chest pain and an exercise thallium-201 scintigram positive for focal ischemia was found on coronary arteriography to have a heretofore unreported variant of single left coronary artery with the right coronary artery originating as a branch from the first septal perforator. Proximally, the aberrant vessel coursed through the ventricular septum at the level of the right ventricular outflow tract. A conus artery was absent and this is a possible basis for the focal basal ventricular ischemia and the patient's symptoms.