Bulgarian Cardiology · Published 2024-12-31 · DOI 10.3897/bgcardio.30.e141038
Congenital coronary artery anomalies and acquired coronary artery pathologies are increasingly identifi ed by different imaging modalities. Abnormal aortic origin of a coronary artery from the opposite sinus is estimated at 0.7%. Echocardiography may have an incremental value in these complex patients often requiring multimodality diagnostic approach. We present the case of a female patient with a single coronary artery identifi ed by angiography with left main course between the aorta and right ventricular outfl ow tract. We also briefl y list a number of different clinical scenarios in patients with structurally normal hearts, with congenital heart disease and patients after cardiac surgery or interventions. These are exemplifi ed by different echocardiographic, angiographic and tomographic images. 
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