title: Congenital absence of left circumflex coronary artery presented with vasospastic angina and myocardial bridge in single left coronary artery.
abstract: Congenital absence of left circumflex coronary artery (LCX) is a very rare congenital anomaly of the coronary circulation, and few cases have been reported in the literature. We report a case of a 48-year-old male who had congenital absence of LCX presented with vasospastic angina. Routine coronary angiography showed congenital absence of the LCX, typical myocardial bridge in the mid left anterior descending coronary artery (LAD) and super-dominant right coronary artery (RCA). The dominant LAD showed a spastic appearance at the baseline coronary angiography and significant spasm was induced by incremental intracoronary acetylcholine (ACh) provocation test at mid LAD where the myocardial bridge site was observed and was extended to the distal LAD. Typical anginal chest pain was documented during the Ach provocation test and the patient was stabilized with conventional anti-anginal medication. Precise morphological and functional evaluation of the anomalous coronary artery is important for selecting the best treatment modality and better prognosis.
authors.forename: Young Kyung
authors.initials: YK
authors.lastname: Yoon
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.forename: Soon Yong
authors.initials: SY
authors.lastname: Suh
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000209:etiology*; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D054084:Myocardial Bridging / Q000150:complications / Q000000981:diagnostic imaging