Type IV dual left anterior descending artery misdiagnosed as chronic total occlusion

Coronary artery anomalies are rare and generally benign clinical situations seen in 1.3% of the total population (1). Dual left anterior descending artery (LAD) has a variant course and is formed from two branches of LAD defined as short and long LAD. Several types of LAD have been described in the literature (2-4). Type IV dual LAD is a very rare form. The short LAD originates from left main coronary artery (LMCA) and terminates proximally in anterior interventricular sulcus (AIVS) giving off diagonal and septal branches. The long LAD originates from right sinus Valsalva passing through the anterior of infundibulum of the right ventricle and terminates in distal AIVS. In this case report, we present a patient with type IV dual LAD misdiagnosed as chronic total occlusion of LAD