ST elevation myocardial infarction in patients with anomalous left main coronary artery: Case series and review of the literature

Anomalous left main coronary artery is rare. We present four cases where anomalous left main coronary artery was diagnosed during emergent cardiac catheterization for ST elevation myocardial infarction. Procedural characteristics, technical challenges, and relevant literature are discussed. •Anomalous left main coronary artery comprises only 1.3% of coronary anomalies•Anomalous coronary arteries may complicate the diagnosis and treatment of STEMI•Four cases of anomalous left main diagnosed at angiography during STEMI are shown•Unique procedural challenges are addressed and strategies discussed