Single coronary artery from the right sinus of Valsalva

A case of a single coronary artery originating from the right coronary sinus and bifurcating into left coronary artery (LCA) and right coronary artery (RCA) in a 74-year-old woman, with a non ST elevation acute myocardial infarction (NSTEMI) is described. The diagnosis was made with coronary angiography, that ruled out stenosis, and showed normal LCA and RCA branching. The connection path of LCA, with the opposite cusp, was defined retroaortic by multislice computed tomography (CT). The variants of this coronary anomaly, together with their clinical implications and pathophysiology of AMI are discussed. Multislice CT is fundamental for clinical decision making.