When the LAD Takes Over: An Unusual Cause of Multi-Territory Infarction by a Hyper-Dominant LAD

Abstract

A 62-year-old male presented with acute coronary syndrome (ACS) with anterior and inferior wall ST-elevation myocardial infarction (STEMI). Coronary angiography revealed a rare hyper-dominant left anterior descending (LAD) artery with triple vessel disease (TVD). Following successful thrombolysis with reteplase, the patient was managed with standard ACS therapy and referred for coronary artery bypass grafting (CABG). This report highlights the significance of hyper-dominant LAD in multi-territory ischemia and discusses its implications in management.