Single coronary artery - right

Case contributed by Claus Laufenburg

Presentation

Acute right bundle branch block, familial predisposition for chronic coronary syndrome.

Patient Data

Age: 55 years
Gender: Male

Coronary CTA

ct

Rare case of a single right coronary artery (RCA) with missing left main branch (LM). Two branches of right coronary artery crossing anterior to truncus pulmonalis with small myocardial bridging of the left anterior descending artery (LAD).

Case Discussion

A single coronary artery is a relatively rare often incidental congenital finding, much more frequently detected since the advent of coronary CTA. In this case, a single right artery arises from the aorta. Two arc-like branches cross-over into the territory of the left and circumflex artery anterior to the truncus pulmonalis. The left main artery is absent. The left descending artery shows a circumscript segment of myocardial bridging which might be the cause of the patient's symptoms.

Diagnosis of the exact coronary situs is important because of therapeutic consequences.

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