Anomalous circumflex artery originating from the right coronary sinus as the culprit in acute inferior myocardial infarction

Coronary artery anomalies are rare congenital conditions that are usually detected incidentally during coronary angiography or post-mortem examinations. Although many variants are clinically asymptomatic, they can be fatal in some cases. In this article, we present a 35-year-old male patient who presented with acute inferior myocardial infarction causing complete atrio-ventricular block. Angiography revealed a rare coronary anomaly, the left circumflex artery originating from the right sinus of Valsalva. The lesion, caused by severe stenosis in the proximal segment of this anomalous vessel, was successfully treated with primary percutaneous coronary intervention. This case highlights the diagnostic and therapeutic challenges of such anatomic variations in the setting of acute coronary syndrome and reviews the current literature on interventional strategies.