Unrecognized Inter-Coronary Communication in a Case of Hypertrophic Cardiomyopathy

Inter-coronary communication is a rare congenital anomaly, defined as a connection between two patent coronary arteries, and was first described in 1972. We report the case of a 61-year-old Emirati female who presented to the emergency department with chest pain and palpitations, along with a strong family history of cardiac disease. She was initially diagnosed with indolent hypertrophic obstructive cardiomyopathy and accordingly managed; however, the patient remained symptomatic. Further investigations revealed inter-coronary communication between her left circumflex (LCX) and left anterior descending (LAD) coronary arteries. This case highlights the importance of recognizing inter-coronary communications for better outcomes in patients with HOCM, as well as their potential clinical significance with the need for further studies to be done to pinpoint the true significance.