Myocardial infarcts in a patient with a single right sided coronary ostium and interarterial course of the circumflex artery: the role of multi-modality imaging.

A solitary coronary ostium, in the absence of other congenital cardiovascular abnormalities, is a rare finding at angiography, and may be associated with myocardial ischemia and sudden cardiac death. We present a 46-year-old female who presented with a non-ST-segment-elevation myocardial infarct in whom the diagnosis of a single coronary artery with right sided ostium was made during diagnostic coronary angiography. Multi-detector computed tomography and gadolinium-enhanced cardiovascular magnetic resonance were valuable in delineating the extremely rare IIE1 coronary anatomy, the localization and the extent of myocardial necrosis.