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Right anterior oblique caudal projection showing the left coronary artery in right dominant circulation. The left main coronary artery (LM) bifurcates into the
two main left-sided epicardial coronary arteries, the left anterior descending (LAD) artery and the left circumflex (LCx) artery. The LAD extends to the left
ventricular (LV) apex but does not reach the inferior part of the heart because the patient has a big posterior descending branch of the right coronary artery
(RCA). Occlusion of the LAD in this patient would not result in ST-segment elevations in the inferior leads II, III, and aVF. The LCx divides into a large
obtuse marginal (OM) branch subtending the anterolateral part of the LV and small posterolateral (PL) branches. The infero (postero) lateral part of the LV
is subtended by the RCA. In this patient, occlusion of the proximal part of the LCx would result in a lateral ST-segment elevation myocardial infarction
Source: Chapter 4. Coronary Angiography, Multimodal Cardiovascular Imaging: Principles and Clinical Applications
because of the anatomy (small PL branches, large OM branch). The electrocardiography findings would be practically identical if the occlusion were in the
Citation:
Pahlm O, Wagner
GS. Multimodal Cardiovascular Imaging: Principles and Clinical Applications; 2011 Available at:
OM branch. LPL,
left posterolateral
branch.
http://mhmedical.com/ Accessed: May 02, 2017
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