Symptomatic Type IV Dual Left Anterior Descending Coronary Artery

Area of Science:

• Cardiology
• Congenital Heart Disease
• Coronary Artery Anomalies

Background:

• Dual left anterior descending (LAD) coronary artery is a rare congenital anomaly with four recognized subtypes.
• Type IV dual LAD artery, originating from both the left main stem and the right coronary artery, is exceptionally rare, occurring in 0.01%–0.7% of cardiac catheterizations.

Purpose of the Study:

• To report a case of type IV dual left anterior descending coronary artery.
• To highlight the diagnostic findings and clinical presentation of this rare anomaly.

Main Methods:

• Coronary angiography was performed to diagnose the anomaly.
• Clinical presentation and diagnostic test results were analyzed.

Main Results:

• A 49-year-old woman was diagnosed with type IV dual left anterior descending coronary artery during coronary angiography.
• The patient presented with chest pain suggestive of angina pectoris.
• An exercise tolerance test was positive for myocardial ischemia.

Conclusions:

• Type IV dual left anterior descending coronary artery is a rare condition that can present with symptoms mimicking myocardial ischemia.
• Accurate diagnosis through coronary angiography is crucial for understanding the implications of such anomalies.