Anomalous origin of left circumflex artery from right coronary sinus

Case contributed by Dr Vinay V Belaval

Presentation

Exertional chest pain.

Patient Data

Age: 50 years
Gender: Female

CT coronary angiography shows:

  • Right dominant coronary circulation
  • Anomalous origin of left circumflex (LCX) artery is seen from right coronary sinus with common ostium for both LCX and RCA. LCX courses postero-inferior to the aortic root to reenter anterior atrioventricular groove.
  • Left main coronary artery (LMCA) continues as left anterior descending artery (LAD).
  • Few eccentric mixed plaques are noted in proximal LAD causing 20-25% stenosis. 
  • No stenosis in rest of the coronary arteries. 
  • Atherosclerotic wall thickening and calcifications are noted in aortic root.

Case Discussion

Congenital coronary artery anomalies can involve their origin, course and termination.

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