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Rare disease
CASE REPORT
Single right coronary artery with congenital absence of left coronary system
  1. Subramanya G N Upadhyaya1,
  2. Lal Hussain Mughal1,
  3. Derek Connolly1 and
  4. Gregory Lip2
  1. 1 Department of Cardiology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  2. 2 Department of Cardiology, City Hospital, Birmingham, Birmingham, UK
  1. Correspondence to Dr Subramanya G N Upadhyaya, subbugn{at}gmail.com

Abstract

Single coronary artery (SCA) is a very rare coronary anomaly. The accurate diagnosis of the entity requires multimodality imaging of the coronary anatomy. SCA is often incidentally diagnosed when patients are investigated for symptoms of suspected coronary artery disease with invasive or non-invasive coronary angiography. There are no established diagnostic electrocardiographic or echocardiographic criteria to identify the presence of SCA, which makes the diagnosis a far-reaching fruit. We present a young male patient presenting with a non-ST elevation myocardial infarction. He was found to have SCA on invasive coronary angiography, which was subsequently confirmed by CT coronary angiography.

  • cardiovascular medicine
  • interventional cardiology

https://doi.org/10.1136/bcr-2018-228296

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    Footnotes

    • Patient consent for publication Obtained.

    • Contributors SGNU: corresponding author, involved in patient care, performed/reported coronary angiogram and CT coronary angiogram, planned and written the manuscript after literature search and case details and obtained the relevant pictures discussed with the patient regarding the publication and helped in obtaining consent. LHM: involved in discussion and writing the case report, obtained consent form the patient and contributed for writing up the manuscript. DC: consultant for the patient, currently managing the patient with follow-up, reported CTCA and helped in discussion, planning and writing up the case report. GL: parent consultant who supervised the invasive coronary angiogram, involved in planning, discussion and supervised the case report writing and contributed significantly.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.