IMAGES IN REVIEW: Extremely rare variant of the single coronary artery

A58-year-old male patient was admitted for coronary angiography two months after he suffered non-ST elevation myocardial infarction (NSTEMI) of the lateral wall. A coronary angiography (Fig. 1A) showed presence of a single coronary artery arising from the right sinus of Valsalva, comprising three clustered, separated coronary artery ostia (‘‘triple-barrel’’), and absence of significant stenosis. A 64-slice multidetector cardiac computer tomography confirmed this rare variant of the single coronary artery (Fig. 1B–C), as well as the benign anterior course of aberrant LAD to the pulmonary artery (Fig. 1D). Echocardiography demonstrated absence of other cardiac abnormalities. The patient was discharged with optimal medical therapy.