Single Coronary Artery with Anomalous Origin of the Right Coronary Artery from the Distal Portion of Left Circumflex Artery: A Very Rare Case
A 47-year-old man referred to the Cardiac Center of Boushehr University Hospital with atypical chest pain of one-week duration. One year previously, he had developed chronic stable angina, as is defined by the Canadian classification II.\nThe patient’s atherosclerotic risk factors included untreated hypertension and smoking. Serial electrocardiograms (ECG) did not show significant changes, while cardiac troponin I test was positive. Transthoracic echocardiography revealed normal chamber sizes, mild mitral regurgitation, and slightly decreased left ventricular function (ejection fraction = 50%).\nThe patient’s symptoms were relieved with the prescription of anti-ischemic medication. Coronary angiography demonstrated a single coronary artery from the left Valsalva sinus. Moreover, LAD and LCx arteries were in normal position, and there was significant stenosis in the mid-portion of the LAD and the distal portion of the LCx (). A large branch originated from the distal portion of the LCx and tapered toward its proximal portion.\nAortic root contrast injection showed a single coronary artery, which took off from the left coronary sinus, and the right coronary artery (RCA) originated from the distal portion of the LCx. This finding is a rare coronary anomaly with no ischemic result. The patient’s clinical symptoms were due to coronary lesions. Angioplasty and stenting of the LAD and LCx was done. Before discharge, medical therapy (Clopidogrel, Aspirin, Atorvastatin, and Metoprolol) was prescribed for the patient. He was asymptomatic in follow-up visits. The stent was intact in an 8-month follow-up coronary angiography.