eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2019-08-12 7 10 264 266 10.12691/ajmcr-7-10-10 AJMCR201971010 article Mohammed Al-Sadawi 1 Muhammad Ihsan 1 Arismendy Nunez Garcia 1 Muhammad Dogar 1 Jessica Celenza-Salvatore 1 Samy I. McFarlane smcfarlane@downstate.edu 1 Department of Internal Medicine, Division of Cardiology, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203 Congenital coronary artery anomalies are rare disease entities, occur only in 0.3%-5.6% of the general population. These anomalies could lead to serious complications in some cases and is associated with associated with sudden death due to lethal arrhythmias and premature coronary artery disease. Diagnosis of these anomalies is generally made during angiography. In this report, we present a rare case of absent left main coronary artery and anomalous origins of left anterior descending artery and left circumflex artery from right sinus of Valsalva in a 62 year old man presented with non-ST elevation myocardial infarction (NSTEMI). http://pubs.sciepub.com/ajmcr/7/10/10/ajmcr-7-10-10.pdf congenital absence of left main coronary artery anomalous origin of left anterior descending and left circumflex arteries acute non-st elevation myocardial infarction