A rare case of dual left anterior descending artery type 4 in inferior myocardial infarction patient: a case report
European Heart Journal - Case Reports

Abstract
This case highlights a type 4 dual left anterior descending coronary artery anomaly, identified incidentally during coronary angiography.
A 51-year-old male patient presented with acute myocardial infarction, which was successfully treated with thrombolysis and percutaneous coronary intervention. Angiography revealed an anomalous origin of the left anterior descending artery (LAD) from the right coronary artery. Stenting was performed on the right coronary artery and the right posterior descending artery branch.
Type 4 dual LAD is a rare coronary anomaly with potential clinical risks, including sudden cardiac death due to its course between major arteries. Variations in the structure of coronary arteries can present challenges for interventional cardiologists when conducting percutaneous coronary interventions. Accurate coronary anatomy assessment via angiography and computed tomography coronary angiography is crucial for successful percutaneous coronary intervention and surgical planning. Although uncommon, the dual LAD type 4 anomaly is a significant coronary artery variation that interventional cardiologists must consider due to its impact on prognosis and long-term treatment strategies.
Contributors

W Yus Haniff W Isa
Author

Zurkurnai Yusof
Author

Mohamad Fadini Abdul Aziz
Author

Mohd Khairi Othman
Author

Piotr Nikodem Rudzínski
Author

Rami Riziq Yousef Abumuaileq
Author

Daniel Messiha
Author

Franca Morselli
Author
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