Journal of Vascular and Endovascular Therapy

Single Coronary Artery as a Possible Source of Myocardial Ischemia

Context: A Single Coronary Artery (SCA) is а rare congenital disorder. Its clinical presentation varies from asymptomatic to serious ischemic evidence, usually diagnosed by coronary angiography or post-mortem.

Case series: We aim to explain frequency, variety of clinical presentation, related to anatomical variants of the SCA, and to propose an evidence based diagnostic and treatment algorithm. For a 5 year-period among 11,597 consecutive selective coronary angiographies we detected 10 individuals (0.9‰) with a SCA. Acute Coronary Syndrome (ACS) was the most common clinical presentation in the study group, followed by palpitations and stable angina pectoris. Atrial fibrillation and reduced LV systolic function were often evident in the study group. The origin of SCA of the right coronary sinus was more often related to ACS. The origin of SCA of the left coronary sinus was accompanied by rhythm disorders and moderately reduced LV systolic function.

Conclusion: Clinical manifestation, anatomical course, and atherosclerotic involvement of SCA guided the choice of therapeutic strategy, including the method for myocardial revascularization.

Author(s): Viktoria Sasheva Dimitrova

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