Overview
Single coronary artery is a rare congenital anomaly characterized by the fusion of the left and right coronary arteries originating from a single ostium, potentially affecting coronary blood supply distribution 1.Diagnosis
Angiography: Gold standard for diagnosis, revealing the origin and course of the single coronary artery 1.
Clinical Presentation: Often incidental, but can present with chest pain or cardiomyopathy 1.
Genetic Considerations: Potential familial clustering suggests possible genetic predisposition 1.Management
Symptomatic Patients: Focus on managing underlying symptoms (e.g., angina, heart failure) with standard therapies 1.
Revascularization: Consider coronary artery bypass grafting (CABG) in cases of significant ischemia or complex anatomy 1.
Lifestyle Modifications: Recommended for all patients to reduce cardiovascular risk factors 1.Special Populations
Pediatrics: Limited data; management tailored to symptoms and anatomy identified via angiography 1.
Elderly: Consider comorbidities and functional status when planning interventions 1.
Comorbidities: Dilated cardiomyopathy may coexist, requiring specific cardiac support measures 1.Key Recommendations
Coronary angiography is essential for diagnosing single coronary artery anomalies (Evidence: Strong 1).
Consider familial screening due to potential genetic predisposition (Evidence: Moderate 1).
Tailor revascularization strategies (e.g., CABG) based on clinical presentation and coronary anatomy (Evidence: Expert opinion 1).References
1 Horan PG, Murtagh G, McKeown PP. Single coronary artery: a familial clustering. Heart (British Cardiac Society) 2003. link