Work

Left Main Coronary Artery Atresia

Year: 2026

Type: article

Abstract: BACKGROUND: Angina is commonly associated with atherosclerotic epicardial coronary artery disease, but it could be the presenting symptom of a coronary structural anomaly or even a noncoronary cardiac structural pathology. CASE SUMMARY: A 40-year-old man with obesity, hypertension, and hyperlipidemia presented with exertional chest pain and dyspnea. Coronary computed tomographic angiography showed no coronary atherosclerosis. However, there was an absence of a direct left main coronary artery connection to the aortic root, and retrograde filling of the left coronary system from right coronary collateral vessels. Stress echocardiography demonstrated no wall motion abnormality or ventricular arrhythmia. Medical management, including beta-blockade, aggressive risk factor modification, and surveillance, was pursued through shared decision-making. DISCUSSION: Left main coronary artery atresia is an exceedingly rare congenital anomaly that may present as exertional angina mimicking atherosclerotic coronary artery disease. Coronary computed tomographic angiography provides precise anatomical information for the diagnosis, and functional testing helps guide individualized management.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.110235

Authors: Pia Balmaceda, Thomas Anderson, Libo Wang, Brent D. Wilson, Daiyin Lu

Institutions: University of Utah, Intermountain Medical Center, University of Utah Health Care

Language: English

Topic: Coronary Artery Anomalies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850