Duplicity of the circumflex artery, a coronary anomaly: Case report

Abstract

Congenital anomaly of the coronary arteries (CACA) is a rare situation in the population, being accidentally found during coronary angiography due to suspicion of other pathologies. The individual may remain asymptomatic for a long period of time, making diagnosis difficult. Among the coronary irregularities is the circumflex coronary artery (Cx), which has been little reported in the literature. Thus, the present study aims to report a case of coronary anomaly, characterized by the duplicity of the Cx artery with anomalous origin in the right coronary artery, in a previously asymptomatic individual. The patient is a 57-year-old female patient with hypertension, diabetes, smoker and hypothyroidism. The patient sought medical attention due to chest pain of severe intensity, in tightness, associated with dyspnea on moderate exertion, which improved with rest. Coronary angiography showed left ventricular (LV) hypertrophy with preserved contractility and coronary anomaly, highlighting the presence of another Cx artery with anomalous origin in the right coronary artery, without the presence of a malignant pathway. After hospital discharge and outpatient return, the patient continues to be maintained with home drug therapy using enalapril, carvedilol, hydrochlorothiazide, simvastatin, ASA and levothyroxine. Although coronary anomalies are pathologies with a low population incidence, they can be potentially lethal, especially in young people, corresponding to the second leading cause of sudden death related to the cardiovascular system. Upon clinical suspicion, early diagnosis and treatment are of paramount importance.