Mena Salib and Raul Amor
Anomalous coronary arteries are known to occur in the general population at a rate of 1-2% however the significance has been the subject of uncertainty throughout the literature. In particular, there is limited data on the clinical significance of an anomalous left circumflex artery originating from the right sinus of valsalva with only a handful of case reports to be found. The aim of this case report is to add to the body of literature indicating that anomalous left circumflex artery originating from the right sinus of valsalva are not all ‘benign’ but in fact can be ‘malignant’ and can result in a patient developing an acute coronary syndrome. Furthermore, this case also adds to the increasing role of computed tomography coronary angiography in the delineation and characterization of coronary anatomy, in particular acute angulation of take off and the slit-like ostium which under exertion may reduce coronary perfusion. We describe a 38 year old male patient who had a non-ST-elevation myocardial infarction after experiencing exertional angina, without evidence of coronary artery disease or inflammatory carditis, and in whom an anomalous left circumflex coronary artery was subsequently.
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