Single coronary artery with anomalous origin of right coronary artery from distal left circumflex artery

Introduction A coronary artery anomaly (CAA) is a congenital defect of one or more coronary arteries of the heart in terms of origin, number, course and termination of the artery. The exact mechanism of CAA development is not elucidated yet. CAA is associated with some other congenital heart diseases like tetralogy of Fallot, transposition of great arteries and pulmonary valve atresia. Most CAA rest asymptomatic while some show up with dyspnea on exertion, syncope during strenuous exercise, fatigue and chest pain. Diagnosis could be made by conventional coronary angiography (CAG) or computerized tomography (CT) and magnetic resonance imaging (MRI). The incidence of CAA is about 0.3% to 1% in patients undergoing CAG [1].