Absent left circumflex artery and unusual dominant right coronary artery.

A 57 year old, diabetic female presented in emergency department with atypical chest pain. Her physical examination was unremarkable. Routine blood and urine biochemistry were within normal limits. Electrocardiogram showed left bundle branch block, with nonspecific ST-T changes. Chest X-ray and 2D-echocardiogram revealed no abnormality. Coronary angiography demonstrated existence of only left anterior descending artery (LAD) with a large diagonal branch and absent left circumflex artery (Fig. 1). The right coronary artery was superdominant and continued beyond crux, along entire length of left atrioventricular groove, between left atrium and left ventricle, to supply posterior and lateral aspect of left ventricle (Fig. 2).