title: A Rare Case of Single Coronary Artery with Atherosclerotic Lesions Arising from the Right Sinus of Valsalva.
abstract: BACKGROUND
  Congenital coronary anomalies, including anomalous origin, distribution, intercoronary communications, and coronary fistulae occur at a rate of approximately 1% in the general population and are the most incidental findings.
  
  
  METHODS
  A 49-year-old male patient presented to the emergency department with exercise-induced dyspnea and atypical angina pectoris. Coronary angiography (CAG) and contrast-enhanced 320-slice multidetector cardiac computed tomography with subsequent three-dimensional reconstructions revealed a single coronary artery (SCA) arising from the right sinus of Valsalva with a proximal branch giving rise to the left anterior descending coronary artery. The left anterior descending coronary artery shows severe atherosclerotic lesions and it is occluded afterwards. Adenosine stress perfusion cardiac magnetic resonance imaging (MRI) revealed a stress myocardial ischemia at the anterior wall without signs of fibrosis, scar, or necrosis.
  
  
  CONCLUSIONS
  We present an extremely rare case of a SCA, with the solitary vessel arising from the right sinus of Valsalva. In our patient's case, the atherosclerotic lesions and occlusion in the branch supplying the anterior wall were considered eligible for neither percutaneous intervention nor bypass graft surgery.
authors.affiliation: Department of Cardiology, Campus Virchow Klinikum, Charité - University Hospital, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Blaschke
authors.affiliation: Department of Cardiology, Campus Virchow Klinikum, Charité - University Hospital, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Krackhardt
authors.affiliation: Department of Cardiology, Campus Virchow Klinikum, Charité - University Hospital, Berlin, Germany.
authors.forename: Bherous
authors.initials: B
authors.lastname: Kherad
authors.affiliation: Department of Cardiology, Campus Virchow Klinikum, Charité - University Hospital, Berlin, Germany.
authors.forename: Burkert
authors.initials: B
authors.lastname: Pieske
authors.affiliation: Department of Cardiology, Campus Virchow Klinikum, Charité - University Hospital, Berlin, Germany.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.affiliation: Department of Radiology, Campus Mitte, Charité - University Hospital, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Rief
keywords: Cardiac magnetic resonance imaging (MRI); congenital coronary anomalies; coronary heart disease; multidetector cardiac computed tomography; single coronary artery (SCA)