Akhigbe Esiemoghie J, Ezeh Ebubechukwu, Amro Mohammad, Olubowale Olusola, Karlsson Gudjon
Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Internal Medicine, Misr University for Science and Technology, Cairo, EGY.
Cureus. 2022 Apr 1;14(4):e23749. doi: 10.7759/cureus.23749. eCollection 2022 Apr.
Congenital coronary artery abnormalities (CAAs) are very rare in the general population. Among these congenital anomalies, left circumflex artery (LCx) anomaly is the most common. Although many are asymptomatic, a small percentage of patients with this anomaly present with angina-like symptoms. Usually, a majority of these cases are found incidentally during coronary angiography. We present a 71-year-old male with crescendo angina with a positive chemical stress test. Coronary angiography showed an absent LCx and a superdominant right coronary artery (RCA). Although congenital LCx absence is a benign finding, the coexistence of this abnormality with significant atherosclerotic disease in the coronary artery can lead to significant morbidity and mortality in this population. Understanding the embryological and morphological significance of these anomalies is important in adequately diagnosing and managing these patients.
先天性冠状动脉异常（CAA）在普通人群中非常罕见。在这些先天性异常中，左旋支动脉（LCx）异常最为常见。虽然许多患者无症状，但一小部分患有这种异常的患者会出现心绞痛样症状。通常，这些病例中的大多数是在冠状动脉造影时偶然发现的。我们报告一名71岁男性，进行性加重型心绞痛，化学负荷试验阳性。冠状动脉造影显示左旋支动脉缺如，右冠状动脉（RCA）优势。虽然先天性左旋支动脉缺如是一种良性表现，但这种异常与冠状动脉显著的动脉粥样硬化疾病并存可导致该人群出现显著的发病率和死亡率。了解这些异常的胚胎学和形态学意义对于充分诊断和管理这些患者很重要。
