What is the diagnosis and treatment for an anomalous left main coronary artery (LMCA)?

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Last updated: May 19, 2025View editorial policy

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Differential Diagnosis for Anomalous Left Main

  • Single most likely diagnosis
    • Anomalous origin of the left main coronary artery from the right sinus of Valsalva: This is a common congenital anomaly that can lead to symptoms such as chest pain, shortness of breath, or even sudden cardiac death due to compression of the anomalous artery between the aorta and pulmonary artery.
  • Other Likely diagnoses
    • Anomalous origin of the left main coronary artery from the right coronary artery: This anomaly can also cause symptoms due to compression or kinking of the anomalous artery.
    • Anomalous origin of the left main coronary artery from the non-coronary sinus of Valsalva: Although less common, this anomaly can still lead to symptoms and complications.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Anomalous origin of the left main coronary artery from the pulmonary artery: This rare anomaly can lead to myocardial ischemia, infarction, and sudden death if not diagnosed and treated promptly.
    • Coronary artery fistula: Although not directly related to anomalous left main origin, a fistula can cause similar symptoms and complications, and its diagnosis is crucial to prevent further damage.
  • Rare diagnoses
    • Single coronary artery: A rare congenital anomaly where only one coronary artery arises from the aortic root, which can increase the risk of cardiac complications.
    • Anomalous origin of the left main coronary artery from the ascending aorta: A rare anomaly that can cause symptoms due to compression or kinking of the anomalous artery.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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