Korean J Pediatr.  2015 Jan;58(1):37-40. 10.3345/kjp.2015.58.1.37.

A rare type of single coronary artery with right coronary artery originating from the left circumflex artery in a child

• Kim JM
• Lee OJ
• Kang IS
• Huh J
• Song J
• Kim G

• KMID: 2284466
• DOI: http://doi.org/10.3345/kjp.2015.58.1.37

Abstract

The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular follow-up.

Keyword

Coronary artery; ST change; Coronary angiography; Child

MeSH Terms

Adolescent
Arteries*
Chest Pain
Child*
Constriction, Pathologic
Coronary Angiography
Coronary Vessels*
Depression
Echocardiography
Electrocardiography
Emergency Service, Hospital
Exercise Test
Female
Humans
Myocardial Ischemia