Single coronary artery from right coronary sinus presenting with acute coronary syndrome

A single coronary artery is a rare coronary artery anomaly. A 39 year-old female underwent coronary angiography for unstable angina. This revealed a common coronary trunk arising from the right sinus of Valsalva giving rise to a right coronary artery (RCA) and a long left main trunk further dividing into a Type-I left anterior descending artery (LAD) and co-dominant left circumflex coronary artery. Distal RCA showed a discrete lesion in the posterior descending artery. Her treadmill test (TMT) was negative for reversible ischaemia. Considering her stable condition and TMT results, she was discharged on medical treatment.