Wellen's syndrome in a Rare Variant of Single Coronary Artery

Coronary artery anomalies, a rare entity, are usually asymptomatic and are diagnosed incidentally. Anomalous origin of the right coronary artery from the left anterior descending artery is a rare variation of the single coronary artery anomaly. Wellen's sign occurs due to either critical stenosis in the proximal left anterior descending artery or coronary steal phenomenon. Here we report a case of a 57-year-old gentleman where these phenomena contributed together leading to Wellen's syndrome due to anomalous origin of the right coronary artery. He underwent successful coronary artery bypass grafting for triple vessel coronary artery disease.