Article Text

Rare disease
Congenital absence of left circumflex artery with a dominant right coronary artery
  1. Fariha Sadiq Ali1,
  2. Sohail Abrar Khan1,
  3. Javed Majid Tai1,
  4. Saulat Husnain Fatimi2,
  5. Sajid Hameed Dhakam1
  1. 1
    Aga Khan University Hospital, Medicine, Stadium Road PO Box 3500, Karachi, 74800, Pakistan
  2. 2
    Aga Khan University Hospital, Surgery, Stadium Road PO Box 3500, Karachi, 74800, Pakistan
  1. Fariha Sadiq, fariha.sadiq{at}


Case 1: a 40-year-old man was admitted to our hospital with progressively worsening post myocardial infarction angina. Cardiac catheterisation was performed, which showed total occlusion of the left anterior descending artery (LAD) and the left circumflex artery (LCX) was not visualised. The right coronary artery (RCA) was a large artery supplying the left ventricular inferior and posterolateral walls and filling the LAD artery in retrograde. The patient was referred for coronary artery bypass grafting. Peroperative findings confirmed the angiographic evidence of congenitally absent LCX artery.

Case 2: a 39-year-old man with a family history of premature coronary artery disease underwent coronary angiography for the work-up of chest pain. A coronary angiogram showed normal LAD artery and absence of left circumflex system. The RCA was superdominant. An aortogram confirmed no anomalous origin and true absence of LCX artery.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

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