Congenital anomaly of coronary artery: absence of left circumflex artery

Abstract

The prevalence of congenital coronary artery anomalies is approximately 1% in the general population. They are a common cause of sudden death in younger persons. Congenital absence of the left circumflex artery is usually a benign condition but can cause symptoms of exertional angina. We present a case of a 59-year-old female who presented with complaints of chest pain. She was evaluated by the cardiology service. An invasive angiogram identified the absence of the circumflex artery, a large right coronary artery, and large septal and diagonal branches of the left main coronary artery possibly as a compensatory mechanism to supply blood to the LCx territories. It is important to define coronary anatomy as anomalies dictate which cardiac intervention should be attempted in cases of ischemia. ARTICLE HISTORY

Reply to Letter to the Editor: “Reevaluating the Case of an Allegedly Absent Circumflex Artery: A Detailed Analysis of İnce et al.’s Report”

“… 4 A very large-sized and dominant RCA courses through the left atrioventricular groove and gives branches that supply the posterolateral site of the left ventricle in our case, in concordance with current literature, as shown in Figure 2 . Similar cases were presented by Rawala et al 5 ( Figure 3 ) and Hong et al 6 ( Figures 4 and 5 ).…”

Congenital absence of the left circumflex artery associated with RCA dominancy: Case report

“…In a normal heart, RCA and LCX pass the atrioventricular groove and make a circle to perfuse their territories. In cases with a small or absence of LCX, having a developed and dominating RCA compensates for posterolateral and lateral wall blood supply beside RCA's natural territory which is the right and inferior heart wall [7,8].…”