Key result
Malignant inter-arterial single coronary artery prompts surgical referral in woman with chest pain and LBBB.
Why the study?
Single coronary artery with an inter-arterial course carries an increased risk of arrhythmia or sudden cardiac death, warranting early recognition and detailed anatomical characterization.
Case Report (n=1)
Highlights the importance of multimodality imaging in identifying rare, potentially malignant single coronary artery anomalies in symptomatic patients.
Alerts to SCD risk in symptomatic elderly with anomalies; leaves open optimal screening and management strategies.
Single coronary artery (SCA) is a rare congenital coronary anomaly arising from a solitary ostium, supplying the entire myocardium. Often asymptomatic and incidental, those with inter-arterial courses carry an increased risk of arrhythmia or sudden cardiac death (SCD). We report a case of SCA in an elderly woman with recurrent chest pain and left bundle branch block (LBBB). Angiogram revealed an anomalous Lipton type R-IIb SCA arising from the right coronary sinus with a malignant inter-arterial course confirmed by coronary CTA. She was referred for surgery due to the risk of SCD and malignant arrhythmia. SCA represents a rare but clinically significant coronary anomaly, particularly those with a malignant course. Early recognition and detailed anatomical characterization using noninvasive and invasive imaging techniques are crucial for accurate diagnosis and risk assessment.
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Badero et al. (2026) conducted a case report in Single coronary artery (SCA) (n=1). Single coronary artery (SCA) was evaluated. An anomalous Lipton type R-IIb single coronary artery with a malignant inter-arterial course was identified in an elderly woman with recurrent chest pain and LBBB, prompting surgical referral.
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