Published online Dec 26, 2023. doi: 10.4330/wjc.v15.i12.649
Peer-review started: August 17, 2023
First decision: September 29, 2023
Revised: October 13, 2023
Accepted: November 13, 2023
Article in press: November 13, 2023
Published online: December 26, 2023
Processing time: 129 Days and 20.7 Hours
Isolated single coronary artery is a rare congenital anomaly. R-I subtype single coronary artery is even rarer. In this subtype, a very large right coronary artery extends in the coronary sulcus to the anterior base of the heart where it produces the left anterior descending coronary artery. Currently, only a few case reports are available in the literature for this anomaly.
Here, we report the case of a 62-year-old woman who presented to the cardiology clinic with decreased exercise tolerance and poor blood pressure control. The patient underwent coronary angiography (CAG) and emission computed tomography (ECT). CAG images revealed a single gigantic right coronary artery (R-I type) arising from the right coronary sinus with branches supplying the left coronary territory. The ECT results confirmed myocardial ischemia at the location of the absent left coronary artery. The ECT findings confirmed that ischemia was consistent with the vascular loss location in CAG images. In such anomalies, there is a compensatory widening of the coronary artery lumen. Medical treatment was administered, and the patient was discharged.
Isolated single coronary arteries are associated with ischemia and potentially fatal acute coronary events. Hence, controlling risk factors is critical.
Core Tip: We present the rare case of an elderly woman with an isolated single right coronary artery (R-I subtype) detected by coronary angiography and myocardial ischemia confirmed by emission computed tomography. Since such an anomaly may be fatal in these patients, providing appropriate medical treatment promptly has a positive effect on their prognosis.