Congenitally Absent Left Circumflex Artery

Area of Science:

• Cardiology
• Medical Imaging
• Anatomical Pathology

Background:

• Congenital coronary artery anomalies are infrequently encountered in clinical practice.
• The absence of the left circumflex artery (LCX) is an exceptionally rare anomaly, with a reported prevalence of approximately 0.003%.

Observation:

• A 68-year-old male presented with symptoms indicative of acute coronary syndrome.
• The patient also exhibited signs of left ventricular dysfunction.
• Coronary angiography revealed the absence of the left circumflex artery (LCX).

Findings:

• The coronary angiogram demonstrated a super dominant right coronary artery (RCA).
• The absence of the LCX was confirmed in conjunction with a hypertrophied RCA supplying a significant portion of the left ventricle.
• This anatomical variation presented unique challenges for diagnosis and management.

Implications:

• Accurate morphological assessment of coronary anatomy is crucial for effective patient management.
• Understanding rare coronary anomalies like absent LCX is vital for interventional cardiologists and cardiac surgeons.
• This case underscores the importance of comprehensive pre-procedural imaging in patients with coronary artery disease.