A Single Coronary Artery Anomaly: Right Coronary Artery as a Branch From the Left Anterior Descending Artery

An anomalous origin of the right coronary artery (RCA) from the left anterior descending artery (LAD), also known as a single coronary artery, is an extremely rare finding in clinical practice. It is usually a benign anomaly; however, symptoms are highly dependent on the course that the anomalous RCA takes after branching off of the LAD. We present a case of a patient who had decompensated heart failure and was detected to have a single coronary artery. The patient was treated with guideline-directed medical therapy with notable improvement in clinical status in the following days. Enhanced awareness of congenital cardiac anomalies may help guide management.