BMJ Case Reports 2017; doi:10.1136/bcr-2016-219184

Anomalous origin of the circumflex coronary artery presenting with ventricular fibrillation cardiac arrest

  1. TainYen Hsia2
  1. 1Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK
  2. 2Barts Heart Centre, St Bartholomew's Hospital, London, UK
  1. Correspondence to Amer Harky, aaharky{at}
  • Accepted 19 February 2017
  • Published 9 March 2017


We report a case of an incidental finding of an anomalous left circumflex coronary artery arising from the right pulmonary artery that effectuated a ventricular fibrillation cardiac arrest in a woman aged 34 years. This rarity was detected during routine work-up to delineate the cause of this arrhythmia. Our patient had a background of double-outlet right ventricle and a ventricular septal defect, which was repaired with a Dacron patch and a left ventricle patch over to the aorta at age 14 months. Angiographic study at the time of her presentation showed anomalous origin of the left circumflex artery originating from the right pulmonary artery; this was discussed in multispecialty team meeting and surgical intervention was recommended; eventually, surgery was performed with reimplantation of the anomalous circumflex artery into the ascending aorta. We highlight the importance of early angiographic studies in patients with known congenital heart defects and emphasise the optimal strategy of treatment.


  • Contributors AH and MG drafted the case report, reviewed, amended and approved by MB. TYH is the responsible cardiac surgeon who operated on the patient.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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