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Updated: Mar 10, 2026

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Coronary Conundrum: Anomalous Pan-Coronary Origin from the Right Sinus with a "Type X" Dual LAD

Abhinand J1, Anil Kumar Choudhary1, Neeraj Rao1

  • 1National Institute of Medical Sciences & Research, NIMS University, Jaipur, India.

Methodist Debakey Cardiovascular Journal
|March 9, 2026
PubMed

Insights

A rare coronary artery anomaly, a dual left anterior descending (LAD) artery, caused acute chest pain. Successful stenting restored blood flow, emphasizing the need to recognize unusual coronary anatomy in clinical practice.

Area of Science:

  • Cardiology
  • Vascular Anatomy

Background:

  • Coronary artery anomalies are rare but can cause significant cardiovascular events.
  • Anomalous origin of coronary arteries requires careful diagnostic consideration.

Purpose of the Study:

  • To report a case of a patient presenting with acute chest pain due to an obstructed dual left anterior descending (LAD) artery.
  • To highlight the diagnostic and therapeutic implications of rare coronary artery variations.

Main Methods:

  • Case presentation of a 49-year-old male with acute chest pain and new-onset right bundle branch block.
  • Diagnostic workup included echocardiography, coronary angiography, and computed tomography angiography.
  • Intervention involved successful percutaneous coronary intervention with a drug-eluting stent.

Main Results:

  • Coronary angiography revealed a rare Type X dual LAD anatomy with an obstructed accessory LAD.
  • Echocardiography showed mild apical hypokinesia and reduced ejection fraction (45%).
  • Successful stenting restored TIMI 3 flow, alleviating symptoms.

Conclusions:

  • Recognizing uncommon coronary artery anomalies is crucial for appropriate patient management.
  • Dual LAD anatomy, though rare, can present acutely and requires tailored interventional strategies.
  • This case underscores the importance of advanced imaging in diagnosing complex coronary artery variations.

Keywords:
CT angiographyType X dual LADanomalous coronarydual LAD

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