Super-Dominant Left Anterior Descending Coronary Artery With Posterior Descending Artery From Septal Perforator Artery: A Rare Case

The posterior descending artery (PDA) usually arise from the right coronary artery or the left circumflex artery. It is extremely rare for the PDA originate from the left anterior descending artery. A 64 years old man presented with angina, palpitation, and cold sweating. Coronary computed tomography angiography revealed a large branch of septal perforator artery coursing through the ventricular septum to gain the posterior interventricular groove, where it continued as the PDA.