Isolated left circumflex coronary artery disease: clinical, electrocardiographic, echocardiographic, and angiographic Characteristics at a tertiary care hospital

Abstract

Introduction: The occurrence of isolated left circumflex coronary artery disease is infrequent
and is observed in only a small fraction of patients undergoing coronary angiography. Due to
the rarity of this specific coronary artery disease, there is a limited body of literature available.
Consequently, the clinical, electrocardiographic, echocardiographic, and angiographic
characteristics of individuals with isolated left circumflex coronary artery disease remain
insufficiently described. Aim and Objective: The goal of this study is to identify distinct
electrocardiographic alterations and angiographic discoveries associated with isolated left
circumflex coronary artery disease. Methodology: This research was carried out at Swamy
Vivekanandha Medical College and Research Institute, located in Thiruchengodu, Namakkal,
Tamilnadu, within the departments of cardiology and general medicine. It is a descriptive
observational study encompassing a total of 55 patients. Ethical approval from the institutional
ethics committee was secured to conduct this study at our hospital. All eligible study
participants, meeting the predetermined inclusion and exclusion criteria, were enrolled in the
current investigation. Observation : A study of 55 patients with isolated left circumflex
coronary artery disease found that, The most common indications for angiogram were
documented myocardial infarction (64%) and stable angina pectoris (36%).The most common
electrocardiographic findings were Q waves (54.5%) and ischemic ST-T changes (72%). 41
patients (74.5%) had a positive treadmill test. A total of 68 stenoses were noted in the left
circumflex coronary artery and its branches, with 36 (53%) central and 32 (47%) peripheral.43 patients (78%) had a single stenosis, 11 patients (20%) had double stenosis, and 1 patient
(2%) had triple stenosis. The average number of risk factors per patient was 2.8.Conclusion:
Isolated left circumflex coronary artery disease is uncommon (3.2%), but most patients have a
good prognosis. Single central stenosis is most common, especially in patients with MI. ECG
changes in lateral leads are common with proximal stenosis, and ECG changes in inferior leads are common with distal stenosis.