Abstract
A single left coronary artery is a very rare anomaly in which only the left coronary artery arises from the aortic trunk by a single coronary ostium and supplies the entire heart. The present report is one of the few describing a patient with an anomalous right coronary artery originating from the middle of the left anterior descending artery. The patient presented with acute myocardial infarction with the culprit lesion on the left circumflex artery. Multivessel angioplasty was successfully performed in a two-step approach: the first for the culprit lesion and the second on the anomalous coronary artery. Decisions about treatment modalities for an anomalous coronary artery should be made only after considering the patient’s clinical characteristics and performing additional imaging diagnostics with a clearly defined coronary anatomy.