Single left coronary artery with microfistula communicating with the left ventricle: a case report]

A 79-year-old man with lung cancer undergoing chemotherapy and radiation complained of chest pain. Coronary angiography revealed that the right coronary artery arose from the distal branch of the left circumflex artery. In addition, a left coronary artery-to-left ventricular microfistula was recognized coincidentally. Multidetector row computed tomography revealed no other cardiac anomalies besides the single left coronary artery. No evidence of ischemia was noted during exercise stress myocardial scintigraphy. No vasospasm provocation study was performed, as it was considered to be potentially life-threatening for a patient with the single coronary system. In general, single coronary artery may occasionally represent a potentially fatal condition, so careful attention must be paid to its anatomical features.