Anomalous origin of the left circumflex coronary artery from the right aortic sinus of valsalva and sudden death

Origin and distribution anomalies of the left anterior descending artery in 70,850 adult patients: Multicenter data collection

“…Six cases did not show atherosclerotic involvement, while cases 7 and 9 had ST segment and T-wave changes in rest electrocardiography (Table 2). Several theories have been proposed to explain the mechanism of non- atherosclerotic ischemia in patients with anomalous origin of the LMCA from the RCA or the RSV [3,[15][16][17]. Similar mechanisms are considered to be related to ischemic events seen in the anomalous LAD cases: (1) compression of the LMCA by aorta and the pulmonary trunk, (2) slit-like orifice produced by acute-angle takeoff of the LMCA from the RSV or the RCA, (3) myocardial squeezing, (4) vasospasm, and (5) small artery.…”

Left circumflex coronary artery originating from distal right coronary artery: An unusual case with 13-year follow-up

“…The mechanism appears to be caused by the reduction in the effective cross-sectional area for blood flow when the anomalous artery passes between the aortic and the pulmonary artery root [4]. Although origination of the circumflex coronary artery as a proximal branch of the right coronary artery is accepted as a benign condition, sudden death and myocardial infarction have been reported in these patients even in the absence of atherosclerosis [5,6]. The reason for this pathogenicity could be repeated compression of the vessel by dilatation of the aortic root or angling as a result of its retroaortic position [7].…”

Anomalous Origin of the Circumflex Branch from the Right Coronary Artery

“…Although this anomaly is classified as benign and asymptomatic, a few cases of sudden death, myocardial infarction and angina pectoris in the absence of atherosclerotic lesion have been reported (Corrado et al, 1994).…”