A rare case of anomalous single coronary artery with absent right coronary artery

The presence of a single coronary artery supplying the entire myocardium is an unusual anomaly. Anomalies of coronary arteries may be found incidentally in 0.3-1% of healthy individuals. Most coronary anomalies described in the literature are cases in which the origin of a given coronary artery is anomalous, but very few cases describe the complete agenesis of the ostium of one coronary artery. The congenital absence of a single coronary ostium is a rare finding with an incidence of 0.024%-0.066% in the general population. Most patients are asymptomatic, and prognoses vary. The presence of a single coronary artery may predispose an afflicted patient to angina, myocardial infarction, congestive heart failure or even sudden cardiac death, especially if this anomaly is compounded by atherosclerotic disease.
This case describes a single coronary artery originating from the left sinus of Valsalva with a dominant left circumflex artery continuing distally into the right side of the heart. Right coronary ostium and Right coronary artery was absent.