Rare Heart Supply by Right Coronary Artery: Single Coronary Artery

HomeRadiologyVol. 309, No. 3 PreviousNext Reviews and CommentaryFree AccessImages in RadiologyRare Heart Supply by Right Coronary Artery: Single Coronary ArteryYigit Can Kartal Yigit Can Kartal Author AffiliationsFrom the Department of Radiology, Basaksehir Cam and Sakura City Hospital, Basaksehir Olimpia Blvd Rd, Istanbul 34480, Turkey.Address correspondence to the author (email: [email protected]).Yigit Can Kartal Published Online:Dec 12 2023https://doi.org/10.1148/radiol.231155MoreSectionsPDF ToolsAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Supplemental material is available for this article.A 62-year-old woman presented with nonspecific chest pain. Physical examination, electrocardiogram, and laboratory tests were normal. Cardiac CT angiography revealed a single coronary artery, originating from the right coronary ostium, encircling the heart, and supplying other coronary territories (Lipton and modified Lipton classification, R-I [1]) (Figs 1, 2; Movies 1, 2). Imaging also showed 20%–40% stenosis in the single coronary artery due to noncalcified plaque (Fig 2B).Figure 1: Images in a 62-year-old woman with single coronary artery. Cardiac CT angiographic images of the heart with three-dimensional processing show the anatomic relation of the right coronary artery to the heart chambers in (A) anterior view, (B) posterior view, and (C) top view.Figure 1:Download as PowerPointFigure 2: Cardiac CT angiographic images in a 62-year-old woman with single coronary artery after additional postprocessing to assess the caliber of the coronary artery. (A) Posterior view with selective rendering of the vascular tree shows the single right coronary artery. (B) Curve-processed image along the plane of the course of the right coronary artery shows multifocal mild luminal narrowing due to noncalcified plaques (arrows).Figure 2:Download as PowerPoint Movie 1: Three-dimensional postprocessing of the heart with cinematic rendering as seen from inferior view shows the anatomic location of the right coronary artery, as examined during cardiac CT angiography.Download Original Video (1.0 MB) Movie 2: Three-dimensional postprocessing of the vascular tree with cinematic rendering illustrates the morphology and caliber of the single coronary artery represented by the right coronary artery.Download Original Video (.4 MB)Single coronary artery is usually accompanied by other congenital heart conditions, its symptoms range from asymptomatic to sudden death, and its diagnosis is usually incidental. In a few literature examples of this condition in children and adults, the diagnosis was made by angiography (2–5). Unlike angiography, the standard for cardiovascular disease diagnosis, cardiac CT angiography provides noninvasive, three-dimensional anatomic information, in addition to intravascular assessment.Our patient received anticoagulant and statin therapy for mild coronary artery disease and showed no new symptoms at 6-month follow-up. Cardiac CT angiography, a valuable tool for cardiovascular diagnosis, facilitated accurate treatment planning.Disclosures of conflicts of interest: Y.C.K. No relevant relationships.References1. Tang S, Tang M, Daniel Iroegbu C, Yang J, Fan C. Case report: congenital coronary artery ring with single left coronary ostium and fistula: a previously unreported anatomy. Front Cardiovasc Med 2021;8:699529. Crossref, Medline, Google Scholar2. Melman YF, Cutlip DE, Das S. A 54-year-old woman with a single coronary artery and watershed ischemia treated with nitrates. JACC Cardiovasc Interv 2015;8(6):e91–e94. Crossref, Medline, Google Scholar3. Chaikriangkrai K, Kassi M, Polsani V, Chang SM. Case report: single coronary artery with ischemia and sudden cardiac arrest. Methodist Debakey Cardiovasc J 2014;10(2):121–123. Crossref, Medline, Google Scholar4. Muhyieddeen K, Polsani VR, Chang SM. Single right coronary artery with apical ischaemia. Eur Heart J Cardiovasc Imaging 2012;13(6):533. Crossref, Medline, Google Scholar5. Xie LJ, Zhang L, Xiao TT, Shen J. Coronary artery fistula between single right coronary artery and right pulmonary artery: a case report and literature review. BMC Cardiovasc Disord 2015;15(1):171. Crossref, Medline, Google ScholarArticle HistoryReceived: May 15 2023Revision requested: July 17 2023Revision received: Aug 11 2023Accepted: Sept 8 2023Published online: Dec 12 2023 FiguresReferencesRelatedDetailsRecommended Articles Imaging Features of Complications after Coronary Interventions and Surgical ProceduresRadioGraphics2021Volume: 41Issue: 3pp. 699-719Anomalous Coronary Arteries That Need Intervention: Review of Pre- and Postoperative Imaging AppearancesRadioGraphics2017Volume: 37Issue: 3pp. 740-757Role of Coronary CT Angiography in Spontaneous Coronary Artery DissectionRadiology: Cardiothoracic Imaging2020Volume: 2Issue: 6Abnormalities of the Coronary Arteries in Children: Looking beyond the OriginsRadioGraphics2017Volume: 37Issue: 6pp. 1665-1678CAD-RADS™ 2.0 – 2022 Coronary Artery Disease – Reporting and Data System An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR) and the North America Society of Cardiovascular Imaging (NASCI)Radiology: Cardiothoracic Imaging2022Volume: 4Issue: 5See More RSNA Education Exhibits Out on the Road: Revisiting Coronary Artery AnomaliesDigital Posters2022Rarest Of The Rare: Institutional Case-based Presentation Of Unusual Coronary Artery Anomalies Using 3D-Cinematic RenderingsDigital Posters2021Coronary CTA: Demand of Perfect Technique in the FFRct EraDigital Posters2020 RSNA Case Collection Anomalous origin of the right coronary artery from the left sinus of ValsalvaRSNA Case Collection2020Subclavian Stenosis with Pre-StealRSNA Case Collection2021Accessory Left Hepatic ArteryRSNA Case Collection2022 Vol. 309, No. 3 Metrics Altmetric Score PDF download