Elbadawi Ayman, Baig Basarat, Elgendy Islam Y, Alotaki Erfan, Mohamed Ahmed H, Barssoum Kirolos, Fries David, Khan Muhammad, Khouzam Rami N
Internal Medicine Department, Rochester General Hospital, Rochester, NY, USA.
Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA.
Cardiol Ther. 2018 Jun;7(1):119-123. doi: 10.1007/s40119-018-0103-4. Epub 2018 Feb 6.
Single coronary artery is a rare anomaly, which is usually associated with other cardiac congenital abnormalities.
A 56-year-old female presented with unstable angina. The patient reported complaints of typical chest pain on exertion few months prior to presentation, which progressed to become at rest. The pain was associated palpitations and dizziness. Past medical history was significant for hypertension and hyperlipidemia. Vital signs were stable. Physical examination was non-remarkable. Electrocardiogram showed normal sinus rhythm, with intermittent episodes of sinus bradycardia, and non-specific T-wave changes. Trans-thoracic echocardiogram showed normal left ventricular function and no segmental wall-motion abnormalities. Selective coronary angiography showed a normal left main coronary artery arising from left coronary cusp. The left main branched to a normal left anterior descending artery and to the left circumflex artery; a large vessel which supplied also the territory of the right coronary artery (RCA) through its terminal extension. Aortography showed absence of RCA with no other vessels arising from the right or non-coronary cusps. The patient was managed conservatively and discharged home with resolution of symptoms.
We report a rare case of isolated single coronary artery with absent RCA. The patient presented with unstable angina, and was managed conservatively. Cardiologists should be aware of this rare condition, which carries a potential risk of sudden cardiac death.
单冠状动脉是一种罕见的异常情况，通常与其他心脏先天性异常相关。
一名56岁女性因不稳定型心绞痛就诊。患者自述在就诊前几个月，运动时出现典型胸痛，后来发展为静息时也会疼痛。疼痛伴有心悸和头晕。既往病史有高血压和高脂血症。生命体征稳定。体格检查无异常。心电图显示窦性心律正常，伴有间歇性窦性心动过缓及非特异性T波改变。经胸超声心动图显示左心室功能正常，无节段性室壁运动异常。选择性冠状动脉造影显示左冠状动脉主干起源于左冠状动脉窦，正常分支为左前降支和左旋支；一条大血管通过其终末分支还供应右冠状动脉（RCA）的供血区域。主动脉造影显示无RCA，右冠状动脉窦或无冠状动脉窦未发出其他血管。患者接受保守治疗，症状缓解后出院。
我们报告了一例罕见的孤立性单冠状动脉且无RCA的病例。该患者表现为不稳定型心绞痛，并接受了保守治疗。心脏病专家应了解这种罕见疾病，其存在心脏性猝死的潜在风险。
