A rare type of dual left anterior descending artery distribution demonstrated by multislice cardiac computerized tomography in a patient with anterior wall infarction.

Dual left anterior descending coronary artery (LAD) distribution with either of the vessels originating from the left main coronary artery (LMCA) and the right aortic sinus of Valsalva is an extremely rare coronary artery anomaly. Here we discuss a 45-year-old male who presented with non-ST-elevation anterior wall myocardial infarction due to near-total occlusion of the LAD immediately after its origin from the LMCA. The distal interventricular septum was supplied by an additional LAD arising from the right aortic sinus with a long septal course. The anomalous origin and septal course of the latter vessel were confirmed with multislice cardiac computerized tomography. The binary distribution of the LAD limited the extent of ischemic insult to the anterior wall in this case.