Isa W Yus Haniff W, Yusof Zurkurnai, Aziz Mohamad Fadini Abdul, Othman Mohd Khairi, Suliman Ayman
Cardiology Unit, Hospital Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
Department of Internal Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, 16150 Kelantan, Malaysia.
Eur Heart J Case Rep. 2025 Feb 5;9(2):ytaf032. doi: 10.1093/ehjcr/ytaf032. eCollection 2025 Feb.
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.
本病例突出显示了一种4型双左前降支冠状动脉异常，该异常在冠状动脉造影时偶然发现。
一名51岁男性患者出现急性心肌梗死，经溶栓和经皮冠状动脉介入治疗成功。血管造影显示左前降支动脉（LAD）起源于右冠状动脉异常。对右冠状动脉及其右后降支分支进行了支架置入术。
4型双LAD是一种罕见的冠状动脉异常，具有潜在临床风险，包括因其走行于主要动脉之间导致的心源性猝死。冠状动脉结构变异在进行经皮冠状动脉介入治疗时会给介入心脏病学家带来挑战。通过血管造影和计算机断层扫描冠状动脉造影准确评估冠状动脉解剖结构对于经皮冠状动脉介入治疗成功和手术规划至关重要。尽管不常见，但4型双LAD异常是一种重要的冠状动脉变异，由于其对预后和长期治疗策略的影响，介入心脏病学家必须予以考虑。
