Síndrome coronario agudo secundario a hipoplasia grave del tronco y de la arteria descendente anterior

congenital coronary artery anomalies are a diverse group of congenital disorders and an uncommon cause of acute coronary syndrome. we describe the case of a 48-year old woman with severe hypoplasia of the left main and left anterior descending coronary arteries associated with non-stsegment elevation acute myocardial infarction. differential diagnoses and treatment options are evaluated. the patient underwent surgery with favorable outcomes.