Diagonal branches of the left anterior descending artery

Last revised by Assoc Prof Craig Hacking on 09 Feb 2021

Diagonal branches of the left anterior descending coronary artery supply blood flow to the anterior and anterolateral walls of the left ventricle. There are usually denoted as D1, D2, D3, etc.  

There are termed "diagonal" due to them branching from their parent vessel at acute angles. They extend over the left ventricle in a diagonal fashion toward the acute margin and the cardiac apex. They often run parallel to one another and are variable in number (often 2 to 9). If a ramus intermedius artery is present, the diagonal arteries are less prominent and arise more distally. The first diagonal (D1) branch tends to be the most prominent. When the first diagonal is large, the other diagonal vessels tend to be small and run a shorter course.

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Cases and figures

  • Case 1: normal coronary angiogram (DSA)
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  • Case 2: normal CTCA
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  • Figure 1
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