Left circumflex artery

Main artery

Curves from the left main into the left atrioventricular groove beneath the left auricle, rounds the obtuse margin and ends on the posterior surface; in the 5 to 10% who are left dominant it continues to the crux and gives the posterior descending and AV nodal arteries.

Traced from the start

  1. Left (posterior) aortic sinus and left main stem
  2. Left circumflex artery

Detail

Branches
Obtuse marginals, left atrial branches, SA nodal in 40%, posterior descending and AV nodal when left dominant
Supplies
Lateral and posterior (inferobasal) LV wall, left atrium, part of the anterolateral papillary muscle
Runs with
Great cardiac vein in the left atrioventricular groove

When it goes wrong

Circumflex occlusion

Lateral STEMI in I, aVL, V5 and V6, or isolated posterior MI seen only as ST depression in V1 to V3

Circumflex occlusion with a standard 12-lead ECG

No ST elevation in about a third of cases, so a normal ECG does not exclude it; record V7 to V9

Practise this structure

1 question in the bank tagged Coronary Circulation.