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Case Reports
. 2024 Sep 3;16(9):e68585.
doi: 10.7759/cureus.68585. eCollection 2024 Sep.

Unveiling the Rarity: An Anomaly of the Left Circumflex Artery Supplying Left Ventricular Apex and Presenting With Myocardial Infarction

Satyajit Singh  1 , Amratansh Varshney  1 , Abhishek Kumar  1 , Surendra K Naik  1
Affiliations
Case Reports

Unveiling the Rarity: An Anomaly of the Left Circumflex Artery Supplying Left Ventricular Apex and Presenting With Myocardial Infarction

Satyajit Singh et al. Cureus. .

Abstract

Coronary arteries are typically identified based on the myocardial territory they supply. In rare cases of coronary artery anomalies, the apex of the heart may be supplied by arteries other than the left anterior descending artery. While it is more common for the posterior descending artery from the right coronary artery to supply the apex, there are rare instances where the left circumflex (LCX) artery performs this function. This case report describes an unusual occurrence where the left ventricular apex is supplied by an obtuse marginal branch of the LCX artery. We present this case due to its rarity, unique presentation, and the challenges it poses for both medical and surgical management.

Keywords: anomalous coronary arteries; interventional management; left circumflex artery (lcx); left ventricular apex; myocardial infarction.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. (A) ECG showing sinus rhythm, left axis deviation, Q waves in leads III and aVF, and subtle ST segment depression in leads V3 to V5. (B) CAG in AP caudal projection showing the LCX artery giving rise to a large OM branch. The OM branch exhibits ostio-proximal critical stenosis (black arrow) and extends toward the apex of the LV (white arrow). (C) CAG in AP cranial projection illustrating a type I LAD artery. A large OM branch with ostio-proximal critical stenosis (black arrow) descends to supply the apex of the LV. (D) CAG in LAO cranial projection displaying the LAD, LCX, and OM arteries with similar findings. (E) CAG in LAO projection revealing the RCA with significant stenosis in the mid-RCA (black arrow).
CAG, coronary angiogram; LAD, left anterior descending; LAO, left anterior oblique; LCX, left circumflex; LV, left ventricle; OM, obtuse marginal; RCA, right coronary artery
See this image and copyright information in PMC

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