Dual left anterior descending coronary artery

Abstract

The normal anatomy of coronary arteries is well known but there is a great variety on its origin and distribution. Congenital coronary anomalies are uncommon and the vast majority is diagnosed incidentally during coronary angiogram or necropsy. Isolated coronary anomalies are uncommon diseases (0.64-1.3% of all patients who underwent coronary angiography) and the anomalous origin of left anterior descending (LAD) artery from the proximal portion of the right coronary artery or from the right sinus of Valsalva is extremely rare ranging between 1.2-6.1% of all coronary anomalies. We report the case of a 52-year-old obese woman with smoking habit and non-insulin dependent diabetes mellitus who had been complaining of chest pain for two months. Coronary angiography revealed dual LAD coronary artery type IV but we noticed that it is not a typical type IV of Spindola-Franco classification because the major septal perforators did not originate from the short, but from the long LAD artery. Therefore, we have to ask the following question: Is the LAD that we present a typical type IV of Spindola-Franco classification or just a new variant never described before?