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[Myocardial infarction and abnormal origin of the circumflex coronary artery]
A Mahdhaoui1, H Bouraoui, M E Majdoub
1Service de cardiologie, CHU Farhat Hached, 4000 Sousse, Tunisie. Abdallah.mahdhaoui@famso.rnu.tn
Insights
An anomalous origin of the circumflex coronary artery, usually benign, can lead to myocardial infarction. This case highlights the need to re-evaluate the ischemic risk associated with this coronary artery anomaly.
Area of Science:
- Cardiology
- Anatomical Variations
- Ischemic Heart Disease
Background:
- An aberrant origin of the circumflex coronary artery (CCA) is typically considered a benign anatomical variation.
- It is generally not associated with significant ischemic risk or adverse cardiac events.
Observation:
- A 21-year-old male presented with a posterior lateral myocardial infarction.
- Diagnostic workup including electrocardiography, echocardiography, and isotopic imaging confirmed the infarction.
- Coronary angiography revealed an abnormal origin of the CCA without any evidence of stenosis.
Findings:
- This case demonstrates that anomalous origin of the CCA, even without stenosis, can precipitate myocardial infarction.
- The event occurred despite the absence of obstructive coronary artery disease.
Implications:
- The assumption of benignity for all cases of anomalous CCA origin may need re-evaluation.
- Clinicians should consider potential ischemic complications in patients presenting with myocardial infarction and this specific coronary anomaly.
Abstract:
Abnormal origin of the circumflex coronary artery without any stenosis is generally considered benign and without any particular ischemic risk. We report a case of a 21 year old man who suffered a posterior lateral myocardial infarction with objective criteria: electrocardiographic, echocardiographic and isotopic. The patient received thrombolytic therapy at H2. Angiography showed an abnormal origin of the circumflex coronary artery which was free of any stenosis. Certain cases of the circumflex artery anomaly can, therefore, be complicated by myocardial infarction, and the benign nature of the anomaly needs to be re-examined.