Superdominant left circumflex with absence of the right coronary artery: an interesting and very rare coronary anomaly

Marcos Danillo Peixoto Oliveira, Ednelson Cunha Navarro, Thiago Ximenes Ferraz, Fabio Santos Silveira, Glenda Alves de Sá, Helio Jose Castello Júnior, Marcelo José de Carvalho Cantarelli


Coronary artery anomalies (CAA) are congenital changes in their origin, course and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or autopsies. A vessel is considered superdominant when it supplies the myocardium normally perfused by the other vessel. The occurrence of a superdominant left circumflex (LCx) artery supplying the territory of the right coronary artery (RCA) is extremely rare. We present the case of a 64-year-old woman complaining of stable angina at moderate efforts, with a positive treadmill test, referred to angiography, which incidentally revealed a very rare and interesting coronary anomaly circulation pattern.