Case Series Single Coronary Artery from Right Sinus of Valsalva: A Single Center Experience of Seven Cases Kanhai Lalani, 1 M. Sudhakar Rao , 1 Padmakumar Ramachandran, 1 A. J. Ashwal, 1 Abdul U. K. Razak, 1 Tom Devasia, 1 Ganesh Paramasivam, 1 and Pankti Parikh 2 1 Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India 2 Department of Endocrinology, St. John’s Medical College, St. John’s National Academy of Health Sciences, Bangalore, Karnataka 560034, India Correspondence should be addressed to M. Sudhakar Rao; msudhakar88@gmail.com Received 2 March 2022; Revised 15 August 2022; Accepted 5 October 2022; Published 20 October 2022 Academic Editor: Robert Soufer Copyright © 2022 Kanhai Lalani et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Single coronary artery (SCA) is a rare anomaly with a prevalence of 0.024–0.066%. Some anomalies are merely benign anatomical variants, whereas some can result in myocardial ischemia or life-threatening arrhythmia. Case Presentation. We described seven cases in which all three major coronaries emerged from the right sinus of Valsalva via a single ostium and supplied the vast majority of the myocardium. A smaller branch arising from the left sinus supplied a modest quantity of myocardium in some of those few cases. ese SCA variations do not exactly fit into any existing classification. It is unclear whether we need to modify previous classification systems or newer classification systems. Conclusions. SCA is divided based on its anomalous course and is usually a benign condition but it may present with cardiovascular complications. Clinicians should be aware of this entity along with the role of CT angiogram in its diagnosis and management. 1. Background Coronary anomalies are usually incidentally diagnosed during coronary angiogram (CAG), CT coronary angiogram (CCTA), or autopsy studies and affect 0.3–5.6% of the general population [1]. ese anomalies differ in number, location, coronary origin, and ostium orientation. A single coronary artery (SCA) is defined as “an isolated coronary artery that arises from a single coronary ostium and provides blood supply to the entire myocardium” [2]. ey may or may not be associated with structural heart disease. According to the published literature, the prevalence of SCA in the general population is very low, ranging from 0.024 to 0.066% [1, 3]. e majority of SCA are asymptomatic. However, in some cases, severe life-threatening arrhythmias, myocardial infarction, or sudden cardiac death may occur, requiring medical or surgical intervention or coronary revascularisation procedures [3]. 1.1. Case Presentation. We reviewed 28,148 coronary an- giograms performed at the Department of Cardiology, Kasturba Medical College and Hospital in Southern Kar- nataka, from 2014 to 2020 and reported 7 cases of the single coronary artery from the right sinus, including its variant, implying a prevalence of 0.025 percent in our population. We described seven cases of a single coronary artery that originated from the right sinus of Valsalva via a common ostium and supplied the majority of the myocardium. 1.1.1. Case 1. A 59-year-old hypertensive and diabetic fe- male presented with a history of exertional fatigue NYHA (New York Heart Association) class II and nonanginal chest pain for the last 2 years. e electrocardiogram (ECG) and echocardiogram were normal but her treadmill test (TMT) was positive at 8 METS (metabolic equivalents) without any symptoms. e right and left sinus of Valsalva were Hindawi Case Reports in Medicine Volume 2022, Article ID 1513474, 7 pages https://doi.org/10.1155/2022/1513474