Congenital coronary artery anomalies are rare and their incidence is approximately 0.64%–1.3% in population who undergo coronary angiography. Congenital absence of RCA with dominant LCx supplying the whole RCA territory (superdominant) is extremely rare and accounts for about 0.003% of reported coronary anomalies.
Most of the congenital coronary anomalies are benign. The clinical presentation of acute anterior wall ST elevation myocardial infarction in association with complete absence of RCA in our case was a co-incidental finding [Supplementry Video 1].
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