Left anterior descending artery
Left anterior descending artery | |
---|---|
left ventricle (LV) | |
Identifiers | |
Latin | ramus interventricularis anterior arteriae coronariae sinistrae |
Acronym(s) | LAD |
TA98 | A12.2.03.202 |
TA2 | 4143 |
FMA | 3862 |
Anatomical terminology] |
The left anterior descending artery (also LAD, anterior interventricular branch of left coronary artery, or anterior descending branch) is a branch of the
Structure
Course
It first passes at posterior to the
Although rare, multiple anomalous courses of the LAD have been described. These include the origin of the artery from the right aortic sinus.[3]
Branches
The LAD gives off two types of branches: septals and diagonals.
- Septals originate from the LAD at 90 degrees to the surface of the heart, perforating and supplying the anterior 2/3 of the interventricular septum.
- Diagonals run along the surface of the heart and supply the lateral wall of the left ventricle and the anterolateral papillary muscle.
Segments
- Proximal: from LAD origin to, and including, the origin of the first septal branch[4][5] (some definitions say to first diagonal, or to whichever comes first)
- Middle: from proximal segment to halfway of remaining distance to apex.[4][5] A more technical definition is from the proximal segment to the point where the LAD forms an angle, as seen from a right anterior oblique view on angiography, which is often close to the origin of the second diagonal branch.[6]
- Distal: from middle segment to apex,[4][5] or in some cases beyond.[6]
Function
The artery supplies the anterior region of the left ventricle, including: the anterolateral
Widow maker
Widow maker is an alternative name for the anterior interventricular branch of the left coronary artery.[8][2] The name widow maker may also apply to the left coronary artery[9] or severe occlusions to that artery.[10][11]
This term is used because the left main coronary and/or the left anterior descending supply blood to large areas of the heart. This means that if these arteries are abruptly and completely occluded it will cause a massive
From the minute a widow maker heart attack hits, survival time ranges from minutes to several hours. Rapidly progressing symptoms should signal the need for immediate attention. Symptoms of initial onset may include nausea, shortness of breath, pain in the head, jaw, arms or chest, numbness in fingers, often of a novel but imprecise sensation which builds with irregular heart beat. Early symptoms may be mistaken for food poisoning, flu or general malaise until they intensify. A widow maker cannot kill instantly but induces cardiac arrest which may do so within 10 to 20 minutes of no circulation. A victim with no pulse or breath is still alive, living off oxygen stored in the blood and may be able to be rescued if treatment is begun promptly within this window.[14]
Additional images
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Coronary arteries (labeled in red text)
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The arch of the aorta, and its branches.
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Heart attack
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Cardiac vessels
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Human heart with coronary arteries
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Heart coronary territories
References
This article incorporates text in the public domain from page 547 of the 20th edition of Gray's Anatomy (1918)
- PMID 32491498, retrieved 2023-01-05
- ^ ISBN 9780781770125. Retrieved 6 November 2014.
The most worrisome type is the proximal left anterior descending (LAD) MI, often referred to as the widow-maker infarction, which carries a high mortality and is attributed to an occlusion of the LAD before or at the first septal perforator.
- PMID 11839639.
- ^ PMID 27358682.
- ^ )
- ^ PMID 17515392.
- PMID 32491498, retrieved 2023-01-05
- ISBN 9781435441248. Retrieved 6 November 2014.
The LAD is frequently implicated in sudden cardiac death, predominantly in adult males. Clinicians often refer to the LAD as the widow maker because obstruction here predisposes to a high incidence of sudden death.
- ISBN 978-0-323-08535-9. Retrieved 2 March 2015.
- ISBN 978-1-4283-2345-2. Retrieved 2 March 2015.
- ISBN 978-1-60406-186-4. Retrieved 2 March 2015.
- ^ Morgan, David (June 13, 2008). "TV newsman Tim Russert dies of heart attack". Reuters. Archived from the original on June 24, 2008. Retrieved June 13, 2008.
- ^ "How Kevin Smith Survived a 'Widow-Maker' Heart Attack". Live Science. 26 February 2018.
- ^ Kearl, Mary (June 2009). "Surviving a Widow-Maker Heart Attack". AOL Health. Retrieved June 22, 2009.
External links
- Anatomy photo:20:09-0102 at the SUNY Downstate Medical Center - "Heart: The Left Coronary Artery and its Branches"
- Anatomy figure: 20:03-08 at Human Anatomy Online, SUNY Downstate Medical Center - "Anterior view of the heart."