Congenital atresia of the left main coronary artery in an adult: an extremely rare anomaly.

Atresia of the left coronary ostium is one of the rarest congenital coronary anomalies. We describe a 50-year-old male with atypical chest pain and positive exercise stress 201-thallium myocardial scintigraphy, in which coronary angiography revealed atresia of the left main coronary artery and right coronary artery collateral to the left anterior descending and left circumflex arteries. The clinical features, diagnosis and management of the left main coronary atresia in adults are discussed.