Korean Circ J.  2011 Oct;41(10):612-614. 10.4070/kcj.2011.41.10.612.

Anomalous Origin of the Left Circumflex Coronary Artery From the First Diagonal Branch Presented as Acute Myocardial Infarction

• Kim JH
• Ha GJ
• Seong MJ
• Jung JW
• Kim SY
• Moon SH
• Lee YS

• KMID: 2297921
• DOI: http://doi.org/10.4070/kcj.2011.41.10.612

Abstract

Coronary artery anomalies are diagnosed in 0.6 to 1.5% of patients who undergo coronary angiography (CAG). They may present with life threatening conditions but are generally asymptomatic. Recognition and adequate visualization of the anomaly is essential for correct management of the condition. However, in some cases the exact orifice and course of an anomalous coronary vessel cannot be selectively identified by CAG. In this report, a 54-year-old man was admitted to the hospital with acute inferior myocardial infarction and had an anomalous origin of the left circumflex coronary artery (LCX) from the first diagonal branch (D1). In CAG, the right CAG showed no significant stenosis and fortunately we found an anomalous origin of the LCX from the D1. The course of LCX was precisely established by 64-slice multi-detector computed tomography.

Keyword

Coronary vessel anomalies

MeSH Terms

Constriction, Pathologic
Coronary Angiography
Coronary Vessel Anomalies
Coronary Vessels
Glycosaminoglycans
Humans
Inferior Wall Myocardial Infarction
Middle Aged
Myocardial Infarction
Glycosaminoglycans

Figure

• 

  Fig. 1 Coronary angiographic finding. A and B: coronary angiography shows the small artery (arrow) with TIMI flow grade 1 originating from the D1 (arrowhead). C and D: after percutaneous coronary intervention for the small artery, the coronary angiography reveals an anomalous origin of the LCX from the D1. A and C: left anterior oblique cranial view. B and D: left anterior oblique caudal views. TIMI: thrombolysis in myocardial infarction, LAD: left anterior descending coronary artery, LCX: left circumflex coronary artery, D1: first diagonal branch.

• 

  Fig. 2 64-slice multi-detector computed tomography demonstrates an anomalous origin of the LCX coursed to the left atrioventricular (AV) groove from the D1. LAD: left anterior descending coronary artery, LCX: left circumflex coronary artery, D1: first diagonal branch, LA: left atrium, LV: left ventricle.

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