Congenital left circumflex coronary artery atresia detected by 64-slice computed tomography: a case report
Chen-Yuan Liu1, Chi-Wen Juan, Yu-Lin Pai
1Department of Emergency Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
Insights
Congenital absence of the left circumflex coronary artery (LCX) is a rare condition. This case highlights the utility of 64-slice CT in diagnosing this rare coronary artery anomaly in a young patient.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Coronary artery anomalies are linked to sudden cardiac death, particularly in young adults.
- Early detection of structural coronary artery abnormalities is crucial for managing at-risk individuals.
- Congenital absence of the left circumflex coronary artery (LCX) is an exceptionally rare vascular anomaly.
Observation:
- A 17-year-old female presented with exertional dyspnea and chest pain.
- Computed tomography (CT) imaging was utilized for diagnosis.
- The patient was diagnosed with congenital LCX atresia.
Findings:
- The diagnosis of LCX atresia was confirmed using 64-slice CT.
- This represents a rare case of congenital LCX atresia diagnosed via multislice CT.
- Coronary artery anomalies affect approximately 1% of the population, with LCX absence being exceedingly rare (0.003%).
Implications:
- Noninvasive computed tomography (CT) is a preferred diagnostic tool for coronary artery anomalies.
- This case may be the first documented instance of congenital LCX atresia diagnosed by multislice CT.
- Accurate diagnosis of rare coronary artery anomalies is vital for patient management and preventing adverse outcomes like sudden cardiac death.
Abstract:
A variety of coronary artery disorders, including intramyocardial coronary segments and coronary artery anomalies, can result in sudden cardiac death, especially in young adults. The detection of structural coronary artery abnormalities is important in the management of patients at risk of sudden cardiac death. Coronary artery anomalies occur in about 1% of the population. Congenital absence of left circumflex coronary artery (LCX) is a very rare vascular anomaly, and few cases have been reported in the literature, with a frequency of only 0.003% in all patients who underwent coronary angiography. Although coronary catheterization is the gold standard for the evaluation of coronary arterial patency disease, noninvasive computed tomography (CT) is considered the diagnostic method of choice for the detection and evaluation of coronary artery anomaly. Herein, we report the case of a 17-year-old girl who presented with exertional dyspnea and chest pain and who was studied at our emergency department with the final diagnosis of LCX atresia detected by 64-slice CT. She may be the first case of congenital LCX atresia proved by multislice CT.
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