Single Coronary Artery Anomaly as a Different Ethiological Variant of Myocardial Ischemia

The single coronary artery is а rare congenital disorder, a subset of coronary artery anomalies. The clinical presentation varies from asymptomatic to malignant variants and is usually diagnosed during coronary angiography or post-mortem examinations. It may or may not be associated with another congenital heart disease. During the three years period and based on clinical indications, we performed selective coronary angiography of 7,996 patients. We discovered five clinical cases of a single coronary artery, which complies with the frequency of this anomaly 0.06% of the study population. All five clinical cases had moderate left ventricular systolic dysfunction and four of them had sinus rhythm disturbances – supraventricular cardiac arrhythmias or sinus tachycardia. Anomalous coronary anatomy may result in insufficient flow delivery even without coronary obstruction. It is important to specify the course of the ectopic artery. Cardiac ischemia could explain left ventricular systolic dysfunction and rhythm disorders. Significant coronary artery disease had three of them. The main goals of this research are to detect the frequency of single coronary artery anomaly among studied population, to illustrate the variety of clinical presentation of this disorder, related to anatomical variants of the anomaly, and to choose the most appropriate treatment decision, based on the present experience.