ST-Segment-Elevation Acute Coronary Syndrome in a Patient With a Superdominant Right Coronary Artery and a Coincident Absent Left Circumflex Artery

We describe a case of a 42-year-old Caribbean South Asian male with no conventional cardiovascular risk factors who presented with an inferolateral ST-segment-elevation acute coronary syndrome (STE-ACS) with thrombolysis in myocardial infarction (TIMI) thrombus grade 4 in a superdominant right coronary artery (sdRCA) and absent left circumflex (LCx) artery. The healthcare team should be cognizant of rare coronary artery anomalies (CAAs), their pathophysiology, and the individualized management strategies for these related ACS.