Congenital Absence of Right Coronary Artery Complicated with Unstable Angina: A Case Report

Congenital absence of right coronary artery (RCA) complicated with unstable angina is a rare clinical condition that can present with symptoms of myocardial ischemia, arrhythmias, and even sudden cardiac death. We report the case of a 60-year-old woman who presented with a one-month history of nocturnal chest pain with no obvious underlying cause that has worsened over the past week. She was seen at the cardiology clinic and had a Coronary computed tomography (CTA) which showed plaque and severe stenosis in the left anterior descending artery (LAD). Considering a diagnosis of acute coronary syndrome (unstable angina), she was hospitalized. During diagnostic coronary angiography (CAG), it was discovered the patient had a single coronary artery with stenosis of the LAD. An absent right coronary artery was also found. A percutaneous coronary intervention (PCI) was subsequently performed. The patient was discharged home in a stable condition and remained asymptomatic on follow-up.