Acute coronary syndrome in a patient with a single coronary artery arising from the right sinus of Valsalva

Figure 1 Angiographic view. A:Origin of the left main coronary artery in the ostium of the right coronary artery. The ramus posterolateralis (RPL)-branch is occluded; B: The course of the left main coronary artery to the left anterior descending and ramus circumflex; C: Angiographic result of the ramus posterolateralis branch after percutaneous coronary intervention with thrombosuction, balloon dilatation and stent implantation. RCA: Right coronary artery; LMCA: Left main coronary artery; RDP: Ramus descendens posterior; LAD: Left anterior descending; RCx: Ramus circumflex.

Figure 2 Multi-slice computed tomography showed the anomalous left main coronary artery originating from the ostium of the right coronary artery. AO: Aorta; LA: Left atrium; RV: Right ventricle; RCC: Right coronary cusp; LAD: Left anterior descending; RCx: Ramus circumflex.

Figure 3 Reconstructed 3-dimensional image demonstrates that the anomalous left main coronary artery originates from the ostium of the right coronary artery. The LMCA proceeds intraseptal (R-II S subtype). AO: Aorta; LV: Left ventricle; LMCA: Left main coronary artery; RV: Right ventricle; LAD: Left anterior descending; RCA: Right coronary artery; PA: Pulmonary artery.