A transmural myocardial infarction involving the anteroapical wall and apex is identified at autopsy. Occlusion of which coronary artery is the most common cause?

• A Left main coronary artery
• B Right coronary artery
• C Left circumflex artery
• D Left anterior descending artery ✓

Explanation

The left anterior descending artery supplies the anterior wall of the left ventricle, the apex, and the anterior two thirds of the interventricular septum, so its occlusion produces the classic anteroseptal or anteroapical infarct. The RCA supplies the posterior third of the septum and the inferior wall, and the circumflex supplies the lateral wall. Isolated left main occlusion usually causes massive infarction incompatible with survival to hospital.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.