Ramus intermedius in a left dominant circulation

Case contributed by Assoc Prof Craig Hacking


Chest pain

Patient Data

Age: 55 years
Gender: Female

Coronary Angiography

Origins: Normal Dominance: left

Left Main Coronary Artery

(LMCA): Normal.

Left Anterior Descending (LAD): Normal.

1st diagonal branch (D1) - large vessel, normal.

D2 - small vessel, normal.

Intermediate artery (Ix): large vessel, normal.

Circumflex artery (Cx): Normal.

1st obtuse marginal branch (OM1) - small vessel, normal.

Posterior descending artery (PDA) - Normal.

Posterior left ventricular branch (PLV) - Normal.

Right Coronary Artery (RCA): Normal.

Cardiovascular Findings:

Single right sided SVC.

Normal pulmonary venous connections.Pericardium and pericardial space appears unremarkable.

Minor single focus of calcification of the left coronary sinus adjacent to but separate from the the left main origin.

No other structural cardiac abnormalities identified.Ventricular function - not performed (prospective acquisition)


No evidence of coronary atherosclerosis. Normal coronary arteries. Left dominant circulation.

Case Discussion

Examples of common variants in coronary artery anatomy

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Case information

rID: 40286
Published: 16th Oct 2015
Last edited: 22nd Jan 2020
System: Cardiac
Inclusion in quiz mode: Included

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