Acute ST-elevation myocardial infarction (STEMI) in a patient with a single coronary artery successfully treated with primary percutaneous coronary intervention

Abstract

Introduction. A single coronary artery (SCA) is defined as a coronary artery that arises from the sinus of Valsalva and supplies the entire heart. This is a rare congenital anomaly occurring in approximately 0.04–0.13% of the population. SCA can be diagnosed during life by coronary angiography and multislice cardiac computed tomography. There are many anatomical variations of single coronary arteries. Case outline. A 50-year-old man presented with acute ST elevation myocardial infarction (STEMI). Coronary angiography revealed the case of an SCA with left anterior descending artery and circumflex artery arising separately from the right coronary artery which was occluded proximally to their taking-off. Successful primary percutaneous coronary intervention was performed and is reported here in details. This is the first described case of an SCA (classified as R-III and R-III-C by Lipton and Yamanaka, respectively) with a clinical presentation as STEMI. A description of the undertaken management is also provided. Conclusion. Coronary artery anomalies require accurate recognition in order to help cardiologists plan appropriate management of these patients.

Keywords

• single right coronary artery
• acutemyocardial infarction
• primary PCI