A Case of Dual Left Anterior Descending Artery (LAD) With Myocardial Infarction from Short LAD

Abstract

A 61-year-old male patient came to our hospital with acute onset retrosternal chest pain radiating to lest arm with sweating for 3-4 hours. On physical examination, his blood pressure was 150/70 mmHg, and his heart rate was 84 beats/min. Electrocardiography showed ST segment elevation in anterior precordial leads, suggestive of acute anterior wall ST elevation MI (Figure 1). Echocardiography revealed regional wall motion abnormality in LAD artery territory (Video 1). He was urgently taken for coronary angiography which 
revealed presence of dual Left Anterior Descending (LAD) coronary artery. One long LAD was arising from Right Coronary Artery (RCA) which was normal (Figures 2 & 3, Video 2 & 3). Another short LAD was arising from Left Main Coronary Artery (LMCA) and having significant lesion in its proximal part responsible for myocardial infarction (Figure 4, Video 4 & 5). Therefore, his primary coronary angioplasty with stenting was done immediately (Figure 5, Video 6).