Coronary atherosclerosis and a rare combination of congenital coronary anomalies in ST-elevation acute myocardial infarction.

A 68-year-old man with anterior ST-elevation acute myocardial infarction was treated with primary angioplasty of the proximal left anterior descending (LAD) artery. Coronary angiography showed coronary atherosclerosis and a rare combination of congenital coronary anomalies on other coronary vessels (myocardial bridge on mid-LAD and ectopic origin of the circumflex coronary). Coronary angioplasty on the ectopic circumflex was therefore required.