A case of single coronary artery complicated with myocardial infarction Nobuyuki Tanaka 1 , Takashi Yoshino 1 , Tadafumi Oda 1 , Tohru Kobayashi 1 , Yoshiyuki Fudemoto 1 , Kiyoshi Fujimoto 1 , Kazushige Sakaguchi 2 , Kazushige Fujita 2 1Department of Circulatory Dynamics, the Center for Adult Diseases, Osaka 2Third Department of Internal Medicine, Osaka Prefectural Habikino Hospital pp.1087-1090
Published Date 1984/10/15
DOI https://doi.org/10.11477/mf.1404204534
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The single coronary artery may be defined as a congenital cardiac vascular anomaly in which the entire heart is supplied by an artery that arises by one ostium from an aortic trunk. Single coronary artery has been considered a minor coronary anomaly without clinical importance. However, sudden death, myocardial infarction and anginal syndrome have been reported recently in patients with this anomaly. We report a patient with single coronary artery complicated with myocardial infarction.

A 53 year old woman experienced exertional chest pain of 13 months' duration. She had sufferedfrom acute myocardial infarction 27 months prior to admission. An electrocardiogram revealed a QS pattern in V1 to V4 and an inverted T wave in V1 to V5, compatible with anterior myocardial infarc-tion. Left ventriculogram showed akinesis in the anterolateral, apical and partially diaphragmatic wall. Ascending aortogram suggested that the left coronary artery arose from the left sinus of valsalva. An injection into right sinus of valsalva revealed no coronary ostium. A selective left coronary angio-gram demonstrated that the left main coronary artery bifurcated into the left anterior descending artery (LAD) and circumflex artery (LCX). The LAD had a 90% obstruction at segment 7. The LCX, which had a moderate cariber and no segmental stenosis, supplied the area of the heart normally maintained by the right coronary system. The present case was an example of type 1 by Smith's classification. The patient's condition remained stable on medical treatment.

The case of Smith's type 1 of single coronary artery myocardial infarction was reported.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


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