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Case Reports
. 2018 Aug 23;10(8):e3189.
doi: 10.7759/cureus.3189.

Anomalous Supradominant Left Circumflex Artery with Rare, Rudimentary Left Anterior Descending Artery

Ghulam Abbas Shaikh  1 , Ameema Asad  2 , Syed Saadan Ahmed  2
Affiliations
Case Reports

Anomalous Supradominant Left Circumflex Artery with Rare, Rudimentary Left Anterior Descending Artery

Ghulam Abbas Shaikh et al. Cureus. .

Abstract

Anomalies pertaining to the coronary vasculature are rare and generally asymptomatic, however, they can pose life-threatening risks in the form of sudden cardiac arrests or myocardial ischemia. We present a rare anomaly of a supradominant left circumflex artery (LCX) and a rudimentary left anterior descending artery (LAD). The patient presented in our outpatient department (OPD) with complaints of occasional chest pain and dyspnea on exertion. An exercise tolerance test (ETT) was carried out, which was inconclusive and an electrocardiogram (EKG) revealed a sinus rhythm with a nonspecific ST segment. Due to these findings, an angiography was performed via the trans-radial route using a TIG 5 French catheter (Terumo Medical Corporation, NJ, US). Coronary angiography revealed codominance because of the presence of a rudimentary LAD, a normal right coronary artery (RCA), and an extremely large LCX. As there was no significant stenosis or atherosclerosis in the coronary arteries, pharmacological treatment was chosen. The patient was discharged in a medically stable condition with a routine follow-up planned after one month. The identification of this supradominant LCX is crucial for diagnosis in possible future circumstances of percutaneous coronary intervention or coronary artery bypass grafting operations, ultimately improving the success rate of invasive cardiac therapies.

Keywords: angina; coronary arteries; coronary artery anomaly.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Rudimentary LAD, which is seen to end abruptly.
LAD: left anterior descending artery
Figure 2
Figure 2. Extremely large LCX is seen coursing toward the apex with the apical LCX supplying the territory of the LAD.
LCX: left circumflex artery; LAD: left anterior descending artery
Figure 3
Figure 3. Normal-sized RCA is seen supplying the PDA.
RCA: right coronary artery; PDA: posterior descending artery
See this image and copyright information in PMC

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