A 62-year-old man dies of acute myocardial infarction. At autopsy, a fresh occlusive thrombus overlies an atherosclerotic plaque in one coronary artery. Which coronary artery is most frequently the site of such thrombotic occlusion?
- A Right coronary artery
- B Left anterior descending artery ✓
- C Left circumflex artery
- D Left main coronary artery
Correct answer: B. Left anterior descending artery
Explanation
The left anterior descending artery supplies roughly half of the left ventricular myocardium including the apex and anterior septum, and is the site of occlusion in about 40 to 50 percent of fatal infarcts, giving rise to anterior and apical infarcts. The right coronary artery accounts for approximately 30 to 40 percent and the circumflex for 15 to 20 percent. Isolated left main occlusion as a cause of infarct is uncommon because patients rarely survive it.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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