Correspondence Address:
Dr. Arun Sharma
Department of Radiodiagnosis, PGIMER, Chandigarh - 160 012
India

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Anomalies of the coronary artery origin are rare, with the majority of them being clinically silent. The most commonly reported anomaly with respect to the left circumflex artery (LCX) is its origin from the right aortic sinus or the right coronary artery with a retro-aortic course. Moreover, twin or dual circumflex arteries have also been reported originating from both the right and the left coronary artery systems, where the accessory LCX was seen originating from the right coronary artery or the right aortic sinus.[1],[2] More recently, the dual origin of the circumflex artery from the main stem of the left coronary artery has also been described. Dual circumflex coronary arteries with the accessory LCX arising from the left coronary sinus [Figure 1] and [Figure 2] are rare. Moreover, in the presence of a normal left main with its normal bifurcation pattern, as seen in the index case, such an anomaly may be missed on catheter angiography. Multi-detector computed tomography angiography allows more accurate delineation of the coronary artery ostium as well as its course and is being increasingly utilized in the diagnostic workup, considering its noninvasiveness, faster acquisition, excellent spatial resolution with multi-planar reconstruction capability.{Figure 1}{Figure 2}

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