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.