Heart Dominated by Solitary Coronary: A Case Report

The prevalence of coronary artery anomalies has been detected in 0.6% to 1.5% of coronary angiography. They are found since birth but usually with no significant symptoms and it does not generally manifest as myocardial ischemia however, malignant outcomes have been reported. Single coronary arteries are rare congenital anomalies in which the entire circulation for the heart is supplied by a coronary artery originating from a single ostium. It is challenging to recognize the anomaly of the patient’s coronaries, experiencing percutaneous coronary intervention (PCI) procedure, undergoing coronary artery surgery, or receiving a prosthetic valve replacement. In our case, we document a patient who underwent PCI for multi-vessel coronary lesions and in whom the atypical origin of the single left coronary artery, with the right coronary artery (RCA) emerging from the distal left circumflex artery (LCX), which was previously undetected.