Single coronary

[bubbaben]

I every one  nice to find this forum...I am a 60 year old  male who has been very atheletic  my whole life...From track and cross country  to heavy weight lifting  for  30 years.....At the age of  50 I started  really  getting tired all the time and had very little energy..so quit everything  .....Have been talking to my doctors for 10 years telling everyone who would listen that it wasnt right to feel that way.......Any how  about  three months ago I had a reaction to nyquil   that sent me to the hospital...All the symptoms were the same as a heart attack   but all the test showed  no heart attack no stroke and no nothing.....They put a great cardiologist on my  case  and it has been a wirl wind of doctors since  .....Tons of test   3 trips to Mayo  Clinic   to meet the best  ACHD  doctor anywhere( in my opinion)   They have found that I have a right coronary artery only....  My  left coronary is missing  and both my  LAD  and  CX    are both attached to opposite sides of the right coronary  Have a few more test to go at Mayo in about a week  to have a TEE  they want to check the back of my heart...They  have told me that  as of now  they dont feel they need to do any kind of surgery....I guess if I were to have a question it would be will I some day in the near future need surgery  or can people live into there  80s and  90s   with this  if treated with meds ....

[kenkeith]

Rich,  Thanks for your response.  The thread will go to the archives, and will be available to you or anyone else who may have an interest.  An anomaly of vessel configuration can be the vessel originates from an abnormal source (LAD and ICX normally orginates from the Left Main) the right coronary ostium (shares source with RCA).  An anomaly configuration can relate to course of blood flow that is abnormal.  And your configuration is right dominant.

What is interesting is how much time by Mayo to map the blood flow.:)  Take care,

Ken

[bubbaben]

Thanks  for the info ...Arteries are clear  had a calcium score of 7  and they say  mild  buildups....  On tricor and aspirin......life is good       Thanks    Rich

[ed34]

Well, first let's go through usual artery anatomy....
The Aorta (large artery from the Left atrium accepting pumped blood) has two coronary arteries attached. One is the Right Coronary Artery and the other is the Left Main Stem. The Left Main Stem would divide into the Left Anterior Descending and the Left CircumfleX. So both sides of the heart are fed by coronary arteries which originate on opposite sides of the Aorta.
In YOUR heart, I think they are saying....
There is only ONE coronary artery connection to the Aorta, the RCA. This vessel divides into three, the LAD(much smaller than expected), the Left Circumflex and the continuation of the RCA. So ALL your feeds come from one connection to the Aorta. 'Usually' the LAD gives rise to vessels called Diagonals which branch off to feed different areas of heart muscle. The Circumflex gives branches called Marginals. In your case, the LAD doesn't seem to have any major branches, but the Diagonals are on the Left circumflex instead. Your system is right dominated because the RCA supplies the Posterior Descending Artery, the one running down the back of the heart.

Personally, Although fascinating, I don't see that it would be a problem if the arteries are clear. Your arteries are laid out differently, but it doesn't mean they are less efficient.

[curmudgen]

The only way to explain in "not doctor" terms is to have this anomalous pattern mapped out for you.  You should carry this description and ECG with you at all times...you never know when you will need to explain this unique pattern to a new doctor or in an emergency situation.

[bubbaben]

Final  Results  from  Mayo Clinic     Anomalous coronary artery anatomy..  One  right coronary ostium gives rise to the  RCA  a diminutive LAD and the left circumflex artery   ...Intra-arterial  intramyocardial LAD  course...The LAD  is diminutive and does not give rise to typical diagonals or septal  perforators...Those vessels arise from branches of the circumflex....Retroaortic course of the left circumflex coronary artery..In addition to supplying the typical circumflex territory this vessel also gives rise to a branch with an appearance similar to a typical first diagonal...This  "first diagonal"  also gives rise to the first septal perforator...Right coronary artery   There is a single right coronary ostium which gives rise to the  RCA  Left circumflex   LAD   and a conal branch...Right  dominant system with RCA  suppling a prominent  PDA.   LAD-  The LAD travels in an intra arterial   intra myocardial course  within the intraventricular septum before emerging into the epicardial fat to run in the interventricular  groove.....    Have no idea what this means but they dont seem as worried as I was so I will relax and wait now.....If  any one can explain in "not doctor "  terms  I would  appreciate it   Thanks   Rich

[ed34]

"I know you have if I remember correctly, an unusual configuration with  vessels on the left side so you may have some insight from your experience."

Well yes and no. The LMS was clear, as was the LCX. The proximal LAD was totally blocked which would have obviously killed me, but the distal LCX grew collaterals into the distal LAD and retrograde filled it. I think this is quite common though with blockages.