Not So Stable Angina: Single Coronary Artery Disease

A single coronary artery (SCA) is a rare congenital anomaly that can be incidentally found as a part of ischemic heart disease or angina workup. A modified Lipton classification is used to categorize the disease. The majority of diseases do not need surgical correction, with the exception of a few conditions. This report presented the case of a 49-year-old man who presented with stable angina with a single coronary artery arising from the right coronary sinus with an intraseptal course of the left main coronary artery. This is categorized as RII-S in the modified Lipton classification and is considered a high-risk anomaly. He underwent an unroofing procedure to decompress the left coronary artery with a resolution of symptoms.