Separate left anterior descending artery and left circumflex artery origins

Case contributed by Craig Hacking
Diagnosis certain


Chest pain

Patient Data

Age: 35 years
Gender: Male

Origins: The LAD and LCx arise separately from the left aortic sinus (hence there is no LMCA).

Dominance: Right

Left Anterior Descending (LAD): Normal.

1st diagonal branch (D1), D2 - small vessels

Circumflex artery (Cx): Normal.

1st obtuse marginal branch (OM1) - very high origin, large vessel, normal.

OM2 - high origin also, normal

OM3, OM4 - normal

Right Coronary Artery (RCA): Normal.

Posterior descending artery (PDA) - Normal.

Posterior left ventricular branch (PLV) - Normal.

Cardiovascular Findings:

Single right sided SVC. Normal pulmonary venous connections.

Pericardial thickening.

No valvular calcification.

Curved MPR showing separate origins.

Case Discussion

The OM1 has a very high origin off the LCx - it can't be a ramus as the LCx and LAD have separate origins.

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