Congenital anomaly of coronary artery: absence of left circumflex artery
Muhammad Shabbir Rawala1, Amna Saleem Ahmed2, Muhammad Asif Iqbal3
1Department of Internal Medicine, WVU-Charleston Division, Charleston, WV, USA.
Insights
Congenital coronary artery anomalies affect 1% of people and can cause sudden death. This case highlights how artery variations impact cardiac interventions for chest pain.
Area of Science:
- Cardiology
- Anatomical Pathology
Background:
- Congenital coronary artery anomalies occur in approximately 1% of the population.
- These anomalies are a significant cause of sudden cardiac death in younger individuals.
- Congenital absence of the left circumflex artery is typically benign but can manifest as exertional angina.
Observation:
- A 59-year-old female presented with chest pain, prompting cardiology evaluation.
- Invasive coronary angiography was performed to assess coronary anatomy.
- The angiogram revealed the absence of the left circumflex artery.
Findings:
- A large right coronary artery was noted.
- Prominent septal and diagonal branches originating from the left main coronary artery were observed.
- These findings suggest a potential compensatory mechanism to perfuse territories normally supplied by the absent left circumflex artery.
Implications:
- Accurate definition of coronary anatomy is crucial for managing patients with coronary artery anomalies.
- Understanding anomalous coronary anatomy guides the selection of appropriate cardiac interventions in cases of myocardial ischemia.
- This case underscores the importance of detailed angiographic assessment in patients presenting with cardiac symptoms and suspected coronary anomalies.
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.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
01:16Arteries and Arterioles