Mboup Waly Niang, Riviere Jean-Francois
Department of Cardiology, Centre Hospitalier François Mitterrand de Pau (CHPAU), Pau, France.
Am J Case Rep. 2025 Jan 9;26:e946330. doi: 10.12659/AJCR.946330.
BACKGROUND A single coronary artery is a rare congenital anomaly of the coronary arteries distribution, with an incidence of only 0.03% in the general population undergoing coronary angiography. RCA arising from the distal circumflex artery is an extremely rare variety. CASE REPORT We report the case of a 63-year-old man who was admitted in our hospital after an inconclusive treadmill stress test. He had no cardiovascular risk factors. He was initially evaluated for palpitations. A subsequent Holter monitor showed monomorphic premature ventricular beats. His coronary artery disease (CAD) pre-test probability was low. Non-invasive exploration with 64-detector-row multi-slice computed tomography (MSCT) was performed to visualize the coronary arteries. It showed a single left coronary artery (LCA) with no significant stenosis. There was no artery emerging from the right sinus of Valsalva. The right coronary artery (RCA) had an abnormal origin, arising from the distal circumflex artery. The patient remained asymptomatic. CONCLUSIONS This case report describes an accidental discovery of an unusual variety of single coronary artery. Computed tomography angiography, very useful in patients with low pre-test probability of coronary artery disease, showed a right coronary artery from the distal circumflex artery.
背景 单支冠状动脉是一种罕见的冠状动脉分布先天性异常，在接受冠状动脉造影的普通人群中发病率仅为0.03%。右冠状动脉起源于旋支动脉远端是一种极其罕见的类型。病例报告 我们报告一例63岁男性病例，该患者在平板运动试验结果不明确后入住我院。他没有心血管危险因素。最初因心悸接受评估。随后的动态心电图监测显示单形性室性早搏。其冠心病（CAD）的预检概率较低。采用64排多层螺旋计算机断层扫描（MSCT）进行无创检查以观察冠状动脉。结果显示为单支左冠状动脉（LCA），无明显狭窄。没有动脉从主动脉窦右窦发出。右冠状动脉（RCA）起源异常，起自旋支动脉远端。患者仍无症状。结论 本病例报告描述了一种罕见类型单支冠状动脉的意外发现。计算机断层扫描血管造影对冠心病预检概率较低的患者非常有用，显示右冠状动脉起自旋支动脉远端。
