Two-directional intercoronary communication: visualization of a very rare coronary anomaly and cause

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To the editor:Communication between normal coronary arteries (ICC) is a substantially rare anomaly.The reason of the fact that two-directional coronary connection causes coronary ischemia in the absence of obstructive coronary artery disease is not clear.This coronary anomaly which is thought to be congenital can be readily visualized on coronary angiography.rnA 58-year-old female patient presented to the cardiology outpatient clinic with angina.The effort test was found to be positive and coronary angiography was performed.It was observed that the circumflex (CX) artery was dominant and the right coronary artery (RCA) was weak by way of the connection.On selective RCA angiography,it was observed that the CX artery was filled more prominently (Figure 1).The patient who was started on diltiazem treatment is being followed up for 6 months and is asymptomatic.
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