11 November 2025
: Case report 
Myocardial Ischemia Secondary to Anomalous Origin of Left Anterior Descending Coronary Artery: A Case Report and Literature Review
Unusual clinical course, Challenging differential diagnosis, Congenital defects / diseases
Osama A. Abdulrahman ABCDEFG 1, Marah M. Alsulami BCDEF 2, Shumukh B. Altuwairgi CDEF 3, Mohammad F. Babgi ABCDEFG 4*, Nabil A. Alrashidi EFG 1, Ehab Kasem ABCDEF 4,5, Mohammed H. Miny ABCDEFG 4, Elnazeer O. Ahmed ABCDEFG 6DOI: 10.12659/AJCR.950091
Am J Case Rep 2025; 26:e950091
Table 1 Literature review of reported cases of anomalous left anterior descending artery origin from right coronary artery.
| Author | Gender | Age | Clinical presentation | LAD course | Diagnostic modality | Management |
|---|---|---|---|---|---|---|
| Dewaswala N. []4 | Male | 50 | Ventricular arrhythmia and anterior STEMI | Mid- and distal LAD arising from proximal RCA | Coronary angiography | PCI |
| Williams E. []5 | Male | 81 | Stable angina | LAD arising from proximal RCA traversing the RVOT | Coronary angiography | CABG |
| Sen G. []6 | Male | 53 | Stable angina | LAS arising from proximal RCA coursing between the aorta and the RVOT with an intramyocardial distal LAD | Coronary computed tomography angiography (CTCA) | CABG |
| Qin X. []7 | Male | 42 | NSTEMI | LAD arising from proximal RCA | Coronary angiography | PCI |
| Mironov A. []8 | Female | 47 | NSTEMI | LAD arising from RCA ostium | Coronary angiography | CABG |
| Nascimento F. []9 | Female | 55 | NSTEMI | LAD arising from proximal RCA, coursing between the aorta and the RVOT | Coronary angiography | PCI |
| Aydar Y. []10 | Male | 53 | Stable angina | Dual LAD arteries: Long LAD arising from distal RCA + short LAD arising from LMCA | Coronary angiography | – |
| Karabay K.O. []11 | Male | 53 | Stable angina with severe LV dysfunction | LAD arising from proximal RCA | Coronary angiography | – |
| Lim Y. []12 | Male | 52 | NSTEMI | Dual LAD: short LAD arising from LMCA and a long LAD arising from proximal RCA and coursing between the aorta and the RVOT | Coronary angiography | PCI |
| Sadeghipour P. []13 | Male | 73 | NSTEMI | Dual LAD: one arising from the LMCA, transforming its course at the midpoint into a diagonal artery + a long LAD arising after the origin of RCA | Coronary angiography | – |
| Ono M. []14 | Female | 66 | Stable angina | LAD arising from RCA distal to the ostium | Coronary angiography | Off bypass CABG |
| Male | 42 | Unstable angina with a history of anterior wall MI | LAD arising from proximal RCA, coursing between the aorta and pulmonary trunk | Coronary angiography | Off bypass CABG | |
| Turhan H. []15 | Male | 58 | IE with chest tightness and dyspnea; severe AR | Dual LAD supply: proximal LAD from LMCA, distal myocardium supplied by RAD from proximal RCA | Echo, CCTA, CAG | Aortic valve replacement with CPB; direct coronary perfusion |