What is the LAD artery?
LAD stands for left anterior descending artery. It is a coronary artery, which is the name given to arteries that supply the heart muscle with blood. The LAD is considered the most important of the three main coronary arteries and is almost always the largest. It’s called the LAD because is on the left side of the heart (left) it runs down the front wall of the heart (anterior descending). The LAD typically supplies over half of the heart muscle with blood, so twice as much as the other coronary arteries. For this reason, a major blockage at the beginning of the LAD artery is often known as the Widowmaker!
Branches of the LAD artery
The LAD gives rise to septal branches and diagonal branches. The septal branches of the LAD supply the septum, which is the wall between the left and right main pumping chambers of the heart. The diagonal branches of the LAD supply the front to sidewall of the heart. Basically the LAD covers a large area! Over 99% of people have at least one diagonal branch of the left anterior descending artery. In about 80% of people, the LAD wraps around the bottom of the heart and supplies the area beyond that.
Blockage of the LAD artery
Significant blockages of the LAD artery can be dangerous simply because the LAD supplies such a large territory. A heart attack involving the LAD is typically more serious than other heart attacks. Usually a blockage of the LAD artery has to be more than 70% to cause significant problems. Even when it looks 70% blocked, more sophisticated tests are often used to determine whether a procedure is required to treat it. It’s now well accepted that a visual estimate of blockage is not a good way of determining how severe the disease it.
If the LAD disease is determined to be significant then a stent is often used to relieve the blockage. Sometimes bypass surgery is advised, and usually a vessel called the LIMA (left internal mammary artery) is used as the bypass vessel and is associated with very good long-term results. Sometimes, if the blockage is towards the end of the artery, medicines alone may be advised.
Comments are purely for informational purposes and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Disclaimer
I found this very informative as I had a stent replaced in LAD and was going to have open heart surgery. My doctor decided to try medicine, etc rather than open heart as I already have two stents in LAD and 40% damage to it. I am very thankful he decided this route, although I do have heart pain. He has me on nitroglycerine patch as well as two other meds. I am doing better, but wonder if I will get back my stamina, or will I have to learn to live with very little. I have always been extremely active, was a runner, never smoked. He seems to think I will get it back. Do you. I am 74 1/2 yrs old, retired military of 26 years.
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I’m 44. 43 when I had chest pains three heart attacks over 4 days. The last one I was at work and ate two aspirin dry. Drove myself 8 miles to the nearest hospital outside Chicago. None of the tests showed anything except for blood enzymes were totally spiked. Never a drug user white 5’10 190# tested concrete for a living. Had a shitty boss and no love in my life. I credit that to my troubles. They ran an angioplasty the next morning. LAD was 99.6% plugged stent was placed in and like 7 meds a day proscribed. Three months later my
Cement company (building materials also French owned) that I worked for cut the lab I worked at and I after 25 years of perfect reviews and feeling that they were a family were also gone. So no work in the construction field after 4 cardiac rehab appointments and countless medical bills wishing I had doc browns DeLorian and never would have ate the aspirins.
I got a calcium scoring done recently. I am 58 years old male with diabetes which is controlled.
The score was 43 (45%). What I was told the score 1 to 80 is low risk. My blood pressure is also controlled by medicine.
My question is how reliable Calcium Scoring is? Particularly for people with other risk factors like diabetes.
https://myheart.net/articles/ct-coronary-artery-calcium-heart-scan-the-facts/
Thank you Dr. Mustafa Ahmed for the information you provide. I thank God for you. God bless you.
want to know the follow up and medications for CABG long term
Typical meds used are aspirin, statin, betablocker and ACE inhibitor
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I wonder if I could/should have had by-pass done. My cardiologist said I couldn’t because there was nothing to by-pass. A lot of times, I still have a very hard time breathing and bad chest pains. I have had a heart attack, thirteen stents, three angioplasty’s and a pacemaker. I just figure that the chest pain is the unstable angina. But one of these times it’s liable to be a massive MI. What else could be wrong?
Hi I have read quite a few articles which are very informative, I have recently had a stress test and Connery angiogram, my report states minor coronary artery disease and mild to moderate irregularity in mid LAD I have been told that this is ok but on reading some articulate here I am understanding that LAD is the main artery, should I be concerned I am 52years old and my mother died hart attack at 62 and my sister had 3 stents at 45 years old it has got me very worried that I should seek second opinion as I feel like a ticking time bomb just waiting when I could be doing something to rectifying it.
Your report essentially says that you have a mild form of coronary artery disease. There do not appear to be any obstructive blockages. The recommendation at this point would be to address risk factors to ensure disease stabilisation. That includes attention to risk factors such as high blood pressure, diabetes, smoking, lifestyle, exercise, diet and such. Your physician may pay attention to cholesterol and treat if necessary.
you can follow my twitter at @MustafaAhmedMD
Hi, my mother 50 years old (non diabetic, non obese, normal blood pressure) recently under went coronary CT angiogram test. Results say that calcium score of 275, and a stenosis of 95 % in mid LAD. Report also says: “Proximal diameter is about 3.5 mm Long segment severe diffuse in proximal and mid LAD in the form of multiple eccentric mixed NRS heterogenous plaques with positive remodelling, Minimal diffuse wall thickening in distal LAD”
Our cardiologist is suggesting us to avoid either bypass or stenting and just maintain life style and constantly monitor the percentages. Can you please suggest us if the above idea is acceptable or a different approach needs to be taken ?
I cant comment on management of cases , films need reviewing and its complex. I would suggest 2nd opinion locally at large center if concerned.