Zhou YP, Wang LL, Qiu YG, Huang SW. R-I subtype single right coronary artery with congenital absence of left coronary system: A case report. World J Cardiol 2023; 15(12): 649-654 [PMID: 38173905 DOI: 10.4330/wjc.v15.i12.649]
Corresponding Author of This Article
Shu-Wei Huang, MMed, Doctor, Professor, Department of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Hangzhou 310005, Zhejiang Province, China. hsw1104@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ya-Ping Zhou, Yuan-Gang Qiu, Shu-Wei Huang, Department of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310005, Zhejiang, China
Lin-Li Wang, Department of Preventive Medicine, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
Co-first authors: Ya-Ping Zhou and Lin-Li Wang.
Author contributions: Zhou YP and Wang LL contributed to manuscript writing and editing and data collection; Qiu YG and Huang SW contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Wei Huang, MMed, Doctor, Professor, Department of Cardiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), No. 54 Youdian Road, Hangzhou 310005, Zhejiang Province, China. hsw1104@163.com
Received: August 17, 2023 Peer-review started: August 17, 2023 First decision: September 29, 2023 Revised: October 13, 2023 Accepted: November 13, 2023 Article in press: November 13, 2023 Published online: December 26, 2023 Processing time: 129 Days and 20.7 Hours
Abstract
BACKGROUND
Isolated single coronary artery is a rare congenital anomaly. R-I subtype single coronary artery is even rarer. In this subtype, a very large right coronary artery extends in the coronary sulcus to the anterior base of the heart where it produces the left anterior descending coronary artery. Currently, only a few case reports are available in the literature for this anomaly.
CASE SUMMARY
Here, we report the case of a 62-year-old woman who presented to the cardiology clinic with decreased exercise tolerance and poor blood pressure control. The patient underwent coronary angiography (CAG) and emission computed tomography (ECT). CAG images revealed a single gigantic right coronary artery (R-I type) arising from the right coronary sinus with branches supplying the left coronary territory. The ECT results confirmed myocardial ischemia at the location of the absent left coronary artery. The ECT findings confirmed that ischemia was consistent with the vascular loss location in CAG images. In such anomalies, there is a compensatory widening of the coronary artery lumen. Medical treatment was administered, and the patient was discharged.
CONCLUSION
Isolated single coronary arteries are associated with ischemia and potentially fatal acute coronary events. Hence, controlling risk factors is critical.
Core Tip: We present the rare case of an elderly woman with an isolated single right coronary artery (R-I subtype) detected by coronary angiography and myocardial ischemia confirmed by emission computed tomography. Since such an anomaly may be fatal in these patients, providing appropriate medical treatment promptly has a positive effect on their prognosis.
