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Anomalous Twin Circumflex Artery Identified By Invasive Coronary Angiography and Non-Invasive Multidetector CT Angiography in A 75 Year Old Caribbean Male
Coronary artery anomalies are clinically important as there have been reports of sudden death, fatal and non-fatal myocardial infarction associated with exercise in persons with certain types of unusual coronary anatomy. Anomalous origin of the circumflex artery is not an uncommon finding; however dual origin of the circumflex artery is a rare anomaly. An extensive search of literature indicates that there have been only two such prior reports, both with nondominant anomalous left circumflex arteries. We describe here the first report of ‘twin’ circumflex arteries with the anomalous dominant circumflex coronary artery arising from the right coronary trunk and a non-dominant circumflex artery from left coronary artery. This was diagnosed by conventional coronary angiography and then confirmed with 64-slice multidetector computed axial tomographic (MDCT) angiography. To the best of our knowledge, this is the first report of twin circumflex coronary artery clearly demonstrated by both invasive and non-invasive techniques. No such confirmation by MDCT angiography has previously been reported in literature.