An Odd Coronary

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This lateral view of the superior interventricular ("LAD") artery shows it making a deep excursion into the septum, giving off two septals at its lowest point and then resurfacing on the distal superior wall. There is no systolic compression. This vessel will often take a shallow intramyocardial course, usually without compression. It might do this for quite a length. This can make it difficult to identify on cardiac CT and for the surgeon to see it at operation. This is in contrast to the shallower, shorter muscle bridges, which often cause severe systolic luminal compression.