Acute coronary syndrome in a patient with a SCA arising from
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Introduction
A single coronary artery (SCA), defined as an artery that arises from the aortic trunk from a single coronary ostium and supplies the entire heart, is rare. Coronary anomalies are inborn errors, and life-threatening symptoms, such as arrhythmias, syncope, myocardial infarction, or sudden death, can occur in up to 20% of patients. However, the majority of anomalies (80%) are benign and asymptomatic. They are usually encountered as coincidental findings during coronary angiography or at autopsy.

The incidence of a left main coronary artery (LMCA) originating from the ostium of the right coronary artery (RCA) is very low (0.05%). There are several classifications for coronary artery anomalies. Lipton proposed a classification of solitary coronary arteries in 1979 which combined two previous classifications defined by Smith in 1950 and Ogden and Goodyer in 1970.

Case:
A 55-year old man presented at the emergency department with progressive typical anginal symptoms for a few days. The patient’s medical history showed no cardiovascular diseases and his sole risk factor was current smoking. Physical examination revealed a blood pressure of 115/80 mmHg with a regular pulse of 64 beats per minute, heart murmurs were absent and there were no signs of heart failure.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432885/
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