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Wrapped left anterior descending artery STEMI: time to revisit

Mochamad Yusuf Alsagaff1,2, Novia Kusumawardhani3

  • 1Department of Cardiology and Vascular Medicine, Airlangga University, Surabaya, East Java, Indonesia yusuf_505@fk.unair.ac.id.

BMJ Case Reports
|January 12, 2021
PubMed

Insights

We present three cases of acute myocardial infarction due to left anterior descending artery occlusion. This rare condition, caused by a dominant left coronary artery, affects inferior leads, leading to atypical ST-elevation myocardial infarction.

Area of Science:

  • Cardiology
  • Anatomy
  • Radiology

Background:

  • Acute myocardial infarction (AMI) typically results from coronary artery disease.
  • ST-elevation myocardial infarction (STEMI) patterns usually correlate with specific coronary artery territories.

Observation:

  • Three patients presented with inferior STEMI, an atypical location for left anterior descending (LAD) artery occlusion.
  • Coronary angiography revealed complete occlusion of the LAD in all cases.

Findings:

  • The cases demonstrated a rare form of left coronary circulation dominance.
  • In these patients, the LAD artery wrapped around the cardiac apex, supplying the posterior descending artery.

Implications:

  • This anatomical variation can lead to inferior myocardial infarction from LAD occlusion.
  • Recognizing this rare coronary circulation pattern is crucial for accurate diagnosis and treatment of myocardial infarction.

Keywords:
Interventional cardiologyIschaemic heart disease

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