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Images in Intensive Medicine
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Available online 4 March 2025
Congenital absence of the circumflex coronary artery
Ausencia congénita de la arteria coronaria circunfleja
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Antonio Padilla-Serranoa,
Corresponding author
antoniopadillaserrano@yahoo.es

Corresponding author.
, Carmen de la Cueva Cocab, Antonio Cárdenas Cruzc
a Unidad de Cuidados Intensivos Cardiovasculares, Servicio de Medicina Intensiva, Hospital Universitario Virgen de las Nieves, Grupo de Investigación PAIDI, criticallab cts 609, Granada, Spain
b Unidad de Cuidados Intensivos Cardiovasculares, Servicio de Medicina Intensiva, Hospital Universitario Virgen de las Nieves, Granada, Spain
c Unidad de Cuidados Intensivos Cardiovasculares, Servicio de Medicina Intensiva, Hospital Universitario Virgen de las Nieves, Profesor de Medicina, Universidad de Granada, Grupo de Investigación PAIDI, criticallab cts 609, Granada, Spain
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A woman consulted due to chest pain. The electrocardiogram (Fig. 1) was compatible with ST-segment elevation acute coronary syndrome. Urgent coronary angiography was performed, showing a right coronary artery (RC) without lesions, and an anterior descending coronary artery (AD) with abundant thrombotic material, encompassing the root of a large diagonal branch (Dg) with small branches that irrigate the territory of a theoretical circumflex coronary artery (Cx) that could not be visualized. The coronary artery lesions were revascularized. Subsequently, coronary computed tomography angiography (Fig. 2) confirmed congenital absence of the Cx. The patient developed cardiogenic shock due to the large ischemic area.

Figure 1
(1.45MB).
Figure 2
(0.34MB).
CRediT authorship contribution statement

All authors have contributed equally to the conception, drafting and final approval of the scientific communication.

Ethical considerations

The instructions for authors and ethical responsibilities have been taken into account. Likewise, the protocols and procedures of the hospital center regarding the publication of patient data, as well as the privacy of the subject, have been followed.

Financial support

The authors declare that they have not received financial support.

Copyright © 2025. Elsevier España, S.L.U. and SEMICYUC
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