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Case Reports
Published online: 2019-03-27
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Super-dominant left circumflex coronary artery (LCx) — an unusual variant of left dominance

Santosh Kumar Sinha, Puneet Aggarwal, Nishant Kumar Abhishekh, Lokendra Rekwaal, Anupam Singh, Vinay Krishna
DOI: 10.5603/FC.a2019.0029

open access

Ahead of print
Case Reports
Published online: 2019-03-27

Abstract

Single coronary artery (SCA) is a rare congenital anomaly of the coronary circulation, the incidence of which has been reported as being from 0.6–1.3% among the population undergoing coronary angiography. The absence of a right coronary artery (RCA) with the origin of the RCA arising from the distal circumflex artery is an exceedingly rare variant of the SCA. The exact incidence of this anomaly is uncertain, with very few cases reported. We here report the case of a 56 year-old diabetic, hypertensive male presenting with acute inferior wall myocardial infarction who was thrombolysed with tenecteplase. Subsequent coronary angiogram demonstrated RCA arising from the distal left circumflex coronary artery (LCx) as its extension, thereby making the LCx super-dominant. RCA had ostial plaquing, and therefore the patient was managed conservatively.

Abstract

Single coronary artery (SCA) is a rare congenital anomaly of the coronary circulation, the incidence of which has been reported as being from 0.6–1.3% among the population undergoing coronary angiography. The absence of a right coronary artery (RCA) with the origin of the RCA arising from the distal circumflex artery is an exceedingly rare variant of the SCA. The exact incidence of this anomaly is uncertain, with very few cases reported. We here report the case of a 56 year-old diabetic, hypertensive male presenting with acute inferior wall myocardial infarction who was thrombolysed with tenecteplase. Subsequent coronary angiogram demonstrated RCA arising from the distal left circumflex coronary artery (LCx) as its extension, thereby making the LCx super-dominant. RCA had ostial plaquing, and therefore the patient was managed conservatively.

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Keywords

myocardial infarction; right coronary artery; super-dominant left circumflex coronary artery; single coronary artery

About this article
Title

Super-dominant left circumflex coronary artery (LCx) — an unusual variant of left dominance

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-03-27

DOI

10.5603/FC.a2019.0029

Keywords

myocardial infarction
right coronary artery
super-dominant left circumflex coronary artery
single coronary artery

Authors

Santosh Kumar Sinha
Puneet Aggarwal
Nishant Kumar Abhishekh
Lokendra Rekwaal
Anupam Singh
Vinay Krishna

References (4)
  1. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990; 21(1): 28–40.
  2. Singh SP, Soto B, Nath H. Anomalous origin of posterior descending artery from left anterior descending artery with unusual intraseptal course. J Thorac Imaging. 1994; 9(4): 255–257.
  3. Cieslinski G, Rapprich B, Kober G. Coronary anomalies: incidence and importance. Clin Cardiol. 1993; 16(10): 711–715.
  4. Garg N, Tewari S, Kapoor A, et al. Primary congenital anomalies of the coronary arteries: a coronary: arteriographic study. Int J Cardiol. 2000; 74(1): 39–46.

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