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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Crescendo Angina Secondary to Congenital Absence of the Left Circumflex Coronary Artery: A Case Report

Esiemoghie J Akhigbe1, Ebubechukwu Ezeh1, Mohammad Amro2

  • 1Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Cureus
|May 6, 2022
PubMed

Insights

Congenital coronary artery anomalies, like absent left circumflex artery (LCx), are rare. Their combination with atherosclerosis can cause serious heart problems, highlighting the need for careful diagnosis and management.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Vascular Anatomy

Background:

  • Congenital coronary artery abnormalities (CAAs) are rare cardiovascular malformations.
  • The left circumflex artery (LCx) anomaly is the most frequent type of CAA.
  • While often asymptomatic, CAAs can manifest as angina-like symptoms in a subset of patients.

Observation:

  • A 71-year-old male presented with crescendo angina and a positive chemical stress test.
  • Coronary angiography revealed an absent left circumflex artery (LCx) and a superdominant right coronary artery (RCA).

Findings:

  • Congenital absence of the LCx is typically a benign finding.
  • The coexistence of LCx anomaly with significant atherosclerotic coronary artery disease poses a risk for substantial morbidity and mortality.

Implications:

  • Understanding the embryological and morphological basis of CAAs is crucial for accurate diagnosis.
  • Effective management strategies for patients with coexisting CAAs and atherosclerosis are essential.
  • This case underscores the importance of considering anatomical variations in the diagnosis of ischemic heart disease.

Keywords:
chest paincongenital anomalies of coronary arteriesexertional chest painleft circumflex artery (lcx)refractory angina

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