Type X dual left anterior descending (LAD) artery masquerading as type 1 LAD — a case report

Abstract Background Dual left anterior descending (LAD) coronary artery is a rare congenital anomaly. To date, eleven variants of dual LAD have been described with three published reports type X LAD. Here, we describe new variant short masquerading as 1 Case presentation A 42-year hypertensive female presented recent onset angina treadmill test positive for inducible ischemia. Coronary angiography showed normal right (RCA). The main (LMCA) originated from the sinus Valsalva (SOV), giving rise to and circumflex (LCX). Appearing angiogram based on its length, presence large bare area in territory (especially at apex) lack septal branches prompted search an additional vessel. Right SOV injection vessel originating separately RCA, which was confirmed be long selective injection, pre-pulmonic course exclusively before wrapping around apex. Computed tomography (CTCA) LAD, defined entry distal interventricular septum ruled out other anomalies. In absence stenotic lesion epicardial coronaries, our case presumed due microvascular dysfunction. She discharged beta-blocker therapy co-existing hypertension asymptomatic follow-up one year. Conclusions could potentially misdiagnosed length. However, active properly diagnose has important clinical implications. Its awareness critical cardiologists cardiac surgeons correctly interpret plan proper management.