A rare coronary anomaly with masked diagnosis: Anomalous left circumflex artery from right pulmonary artery

Abstract

Anomalous origin of the circumflex coronary artery from the pulmonary artery is a rare congenital coronary anomaly. While it generally follows an asymptomatic course, if undiagnosed it may lead to severe clinical outcomes, including sudden death. The condition can be masked by associated defects, so when it is clinically suspected, diagnosis must be confirmed by conventional and/or magnetic resonance angiography, even if echocardiography clearly shows coronary roots. This report describes a patient who underwent neonatal surgery for aortic coarctation and was diagnosed with coronary artery anomaly at 15 months old.

Circumflex coronary artery originating from the right pulmonary artery in adult

“…Anomalous origin of a coronary artery is rare in adults (0.3%–0.9 %) but relatively common in children, especially concomitant with other congenital malformations (3%–36%). 1 Anomalous origin of the circumflex coronary artery (Cx) from the right pulmonary artery (RPA) is less common. 2 In the case of adequate coronary collateralization, the clinical course may be silent.…”