Key result
Primary PCI resolves complete heart block in anomalous dual LAD occlusion.
Case Report (n=1)
Primary angioplasty can successfully restore normal sinus rhythm in patients presenting with acute anterior wall myocardial infarction complicated by complete heart block in the setting of a dual LAD anomaly.
May suggest reversible complete heart block in dual LAD; leaves open need for prospective validation before practice change.
Dual left anterior descending (LAD) artery is a rare coronary anomaly. We present a patient with a rare case of dual LAD, smaller one arising from the left main coronary stem and larger one from right coronary artery who presented with acute anterior wall myocardial infarction with complete heart block (CHB). Temporary pacemaker was implanted and coronary angiogram revealed critical occlusion of proximal LAD which was subsequently revascularized by primary angioplasty using drug-eluting stent (Xience prime, 2.75 × 23 mm) leading to recovery of CHB and restoration to normal rhythm. To the best of our knowledge, this is the first reported case of dual LAD presenting with CHB treated by primary angioplasty reported in the literature.
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Sinha et al. (2017) conducted a case report in Acute anterior wall myocardial infarction with complete heart block and dual LAD (n=1). Primary angioplasty using drug-eluting stent (Xience prime) was evaluated on Recovery of complete heart block and restoration to normal rhythm. Primary angioplasty using a drug-eluting stent successfully revascularized a critical occlusion in a patient with dual LAD, leading to recovery of complete heart block and normal sinus rhythm.
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