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 ....

[bubbaben]

Not sure where all the blood is coming  from  but if  I made it this far  something is working......Trust me I am not complaining   extremely  rare can mean  good......I will see if I can get answer from Mayo  after the TEE  next week....  They think there may be  things they cant see from the front.....Who  knows....But  thank you guys and hope all goes well  for the both of  you

[kenkeith]

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.

I recently answered a post regarding ASD and the pulmonary artery went to the left side and the right side had a different course...."The left coronary artery was a branch of
the pulmonary artery. The right coronary artery filled from the aorta and was grossly dilated; after a shorter delay, the left coronary artery opacified via extensive
collaterals and the contrast was seen streaming into the main pulmonary artery".

I would assume the collaterals develop prior to birth and after birth when the heart is pumping on its own other collaterals may further develop to support the additional stress to the heart.

[ed34]

Thanks for that. You think that a lot of supply will be down to collaterals? and not more profound vessels that may have grown during the development of the heart? I suppose thinking about it, if larger vessels were present, they would have been seen on the angiogram. Does the LAD in such cases still originate from the LMS? or is it retrograde filled?

[kenkeith]

Missing LAD indicates the LAD is not located in the usual configuration...it is a very rare condition. In fact this is the second case in reading and answering more than 10000 heart disease posts. As you can imagine it presents a challenge to determine what contibutaries provide the major source to probably a very diffuse supply with its many collaterals that apparently have served well for years even with rigorous exercise. To survive with a good functioning heart for many years is almost a miracle!

[bubbaben]

I am not missing the LAD  its just not on the left side...  Both the LAD and the  CX  come out of the  right coronary  which they say is  huge...  The CX  is also huge  but the  LAD  is not as big as it should be....  The  cardiologist  came into to my  room  told me that didnt know how I was still alive  that I had a Pete  Maravich  Heart and  now that we know about it  everything should be fine  because I will be watched  for  ever  by  doctors......Thing is I feel good other than all the medicine they put me on now  to  keep  the heart rate down  the blood pressure down  and to keep cholestrol down.....Have always had  ( 40 years)  extremely high  tris and chol....and smoke  2 packs a day  even tho  I worked out.....There is no sign of artery disease  and no blockage to speak of  anywhere   ........I feel that  I have been very lucky   and that some one is watching over me.........When  I hear  more I will post it........PS  have not smoked in 3 months.....

[ed34]

I have heard of a missing Left circumflex and the right coronary artery is super dominant. In such cases, the right coronary artery feeds the right ventricle, back and front, and feeds the back of the left ventricle too. It also in many cases crosses over to feed the lower front of the left ventricle to make up for an inadequate Left Anterior Descending. I have never come across a missing Left Anterior Descending. It will be interesting and very informative if you would be kind enough to keep us informed as regards to your progress, and of course what they discover about the anatomical layout of your arteries.
Very interesting post, thank you for sharing.