Cardiac computed tomography of congenital absent left circumflex coronary artery: A case report

Congenital absent left circumflex coronary artery (LCX) is a very rare anomaly. Only a few cases diagnosed by conventional angiography were reported in the literature. We report a case of congenital absent LCX with angina-like symptoms diagnosed by cardiac computed tomography (CT) scan. A 71-year-old male patient with intermittent chest tightness during exercise was referred to our department for cardiac computed tomography (CT) study. The thallium-201 myocardial perfusion study showed positive finding and the result of treadmill exercise electrocardiogram was inconclusive. No evidence of atherosclerotic coronary artery disease but total absence of LCX was found in the CT study. Knowledge of the clinical manifestations and cardiac CT appearances of this rare anomaly are essential for accurate diagnosis and proper treatment.