A hypoplastic circumflex artery refers to a small-sized circumflex artery (Cx) with a small lumen and a short course.
On this page:
Epidemiology
Hypoplastic circumflex arteries are rarely described in the literature.
Associations
Clinical conditions associated with a hypoplastic circumflex artery include 1,2:
Clinical presentation
A hypoplastic circumflex artery can be an incidental finding on invasive coronary angiography, cardiac CT or cardiac MRI, there have been also reports of syncope, angina or sudden cardiac death as an initial presentation 1-3.
Complications
A hypoplastic right coronary artery can lead to the following conditions 1,2:
- myocardial ischemia
- arrhythmia
- sudden cardiac death
Pathology
There is no clear definition as to when to define a circumflex artery as hypoplastic since there are usually quite many variations. An ample description is a narrow lumen and a short course. In one report a luminal diameter of <1 mm has been suggested 2.
Radiographic features
Usually, the term hypoplastic circumflex artery is used in the case of a short course and a narrow vessel lumen 1-5.
Radiology report
The radiological report should include a description of the following features:
- circumflex artery with course, branches and segments
- left anterior descending artery with course branches and segments
- left main coronary artery and variant anatomy
- right coronary artery origin, course, segments
- coronary artery stenoses with location based on the AHA coronary artery segment model
Treatment and prognosis
Due to an increased risk of arrhythmia, the implantation of an implantable cardioverter-defibrillator (ICD) has been recommended 1.
History and etymology
Hypoplastic coronary artery disease has been first reported by JA Ogden in 1970 4.
Differential diagnosis
The differential diagnosis of hypoplastic circumflex artery includes the following:
- circumflex artery stenosis
- circumflex artery occlusion
Unable to process the form. Check for errors and try again.