ST-Elevation Myocardial Infarction in a Patient with Anomalous Left Anterior Descending Artery and Absent Left Circumflex.

The left anterior descending artery originating from the right coronary sinus is very unusual. An absent left circumflex is very rare with a few reported cases in the literature. We report a combination of a non-dominant left anterior descending artery arising from the right coronary cusp and an absent left circumflex artery in a 60-year-old male presenting with ST-segment elevation myocardial infarction. The patient was managed by percutaneous intervention and recovered well. This case demonstrates an extremely rare combination of coronary anomalies.