The right coronary artery originating from the left anterior descending artery: A variant of single coronary artery anomaly

Although coronary artery anomalies have been accepted as benign conditions, clinical presentations have a large spectrum including chest pain, dyspnea, palpitations, malign arrhythmias, myocardial infarction, syncope and sudden death. An atypical anomalous form of single coronary artery in which the right coronary artery originates from the left anterior descending coronary artery is an extremely rare situaiton. In this report, we presented a case of 63 years old woman who was taken to the coronary angiography due to recurrent chest pain and acute coronary syndrome. Coronary angiography revealed an atypical form of single coronary artery anomaly that the right coronary artery originates from the left anterior descending coronary artery. The treatment strategy was discussed with heart team and patient. Percutaneous coronary intervention (PCI) was performed because of her recurrent chest pain and isolated LAD lesion and preference of the patient. In conclusion, this case is important for demonstrating the feasibility of PCI in patients with single coronary artery anomaly.