So may I introduce to you the artery you’ve been missing for all these years, Italian cardiologists could have sung in a Beatles-style serenade to their patient.

Because when the 64-year-old woman presented to ED with hypertension and a three-day history of chest pain, at rest and on exertion, they made an unlikely discovery.

An ECG showed T-wave inversions in the inferior leads. The patient had an elevated troponin I level of 3.068ng/mL (normal: 0-0.016). And an echocardiogram revealed a left ventricular ejection fraction of 58%, a hypokinetic inferior wall and mild mitral regurgitation.

But when the doctors carried out a coronary angiography, the right coronary artery looked decidedly lonely, with the ostium of the left coronary artery nowhere to be found.