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Setri Fugar [1] and Lydia Issac [1] and Alexis Kofi Okoh [2] and Christelle Chedrawy [3] and Nadia El Hangouche [4] and Neha Yadav [4]

Academic Editor: Kjell Nikus

1, Department of Internal Medicine, John H. Stroger Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA, cookcountyhhs.org

2, Department of Cardiothoracic and Vascular Surgery, Barnabas Heart Hospitals, West Orange, NJ 07052, USA, barnabashealth.org

3, Department of Radiology, John H. Stroger Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA, cookcountyhhs.org

4, Department of Cardiology, John H. Stroger Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA, cookcountyhhs.org

Received May 8, 2017; Revised Aug 23, 2017; Accepted Sep 18, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Congenital absence of the left circumflex (LCX) artery is a rare coronary anomaly with an incidence of 10 in 1495 (0.0067%) patients [1, 2]. Due to its uncommon nature, diagnosis can be challenging, especially among patients who present with acute cardiac symptoms. It may initially be misdiagnosed as complete occlusion of the left circumflex artery [3]. A better understanding of the natural history and clinical implications of this condition may allow us to diagnose and manage this condition with an algorithmic approach. We present a case of congenitally absent left circumflex artery with a superdominant right coronary artery (RCA) detected by coronary angiography and confirmed by coronary CT. Also, a review of previously published cases in literature and their clinical outcomes is presented.

2. Methods

In addition to the present case, a systematic review of case reports/short cases in OVID looking at patients who presented with congenitally absent left circumflex artery was performed. The review only considered papers published in the English language. An electronic search strategy with the keywords Left circumflex AND Absent OR Absence AND Congenital was used. Duration of published papers was defined between and 1946 and October 2016. Definitions used for case-inclusion were (a) age greater than 18 years and (b) diagnosis of left circumflex artery abnormality either by CT/MRI or coronary angiography (Figure 1).

[figure omitted; refer to PDF]

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