DOI: https://doi.org/10.36347/sjmcr.2026.v14i11.011

Pages: 2448-2451

Background. Myxoma is the most frequent benign primary tumour of the heart, and most arise in the left atrium. Congenital coronary anomalies are seen in roughly 1% of coronary angiograms. We found no previous report of the two occurring together. Case presentation. A 66-year-old woman was referred for exertional dyspnoea. Transthoracic echocardiography showed a large, mobile left atrial mass prolapsing into the mitral orifice, with a mean transmitral gradient of 16.8 mmHg. Routine coronary angiography before surgery showed a circumflex artery arising from the right coronary sinus and running behind the aorta. The tumour was excised and she recovered without complications. Conclusion. As far as we know, this is the first description of a left atrial myxoma combined with an anomalous circumflex origin. In our view, coronary imaging before tumour surgery is worth doing even in patients without angina, mainly to know where the coronary arteries run before the heart is opened.