Normal single coronary artery and myocardial infarction

Area of Science:

• Cardiology
• Congenital heart disease
• Myocardial infarction

Background:

• Congenital coronary artery anomalies are rare but can have significant clinical implications.
• Myocardial infarction (heart attack) in young adults is uncommon and often necessitates thorough etiological investigation.

Observation:

• A 21-year-old asymptomatic male presented with electrocardiographic and vectorcardiographic findings suggestive of anterolateral myocardial infarction.
• Cardiac catheterization revealed a single left coronary artery (SLCA) originating from the left aortic sinus.
• This SLCA supplied the entire myocardial mass, including territories typically perfused by both the left and right coronary arteries.

Findings:

• The SLCA was found to be free of atherosclerotic disease.
• This represents a unique presentation of a normal SLCA associated with evidence of myocardial infarction, a previously undocumented correlation.
• The patient's condition highlights the potential for myocardial infarction in the presence of anomalous coronary anatomy, even without obstructive disease.

Implications:

• The presence of a single coronary artery, particularly when associated with myocardial infarction, may indicate an underlying risk for potentially fatal cardiac events.
• Patients diagnosed with single coronary artery anomalies require vigilant cardiovascular surveillance.
• Further research into the pathophysiology and long-term outcomes of myocardial infarction in individuals with single coronary arteries is warranted.