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

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.