Posterior Descending Coronary Artery Arising From a Septal Branch of the Left Anterior Descending Coronary Artery.

A 48-year-old man with hypertension presented with heart failure and reduced left ventricular systolic function. Coronary angiography revealed a non-dominant right coronary artery and a long anomalous branch of the proximal left anterior descending coronary artery that coursed inferiorly to give rise to the posterior descending artery. No epicardial coronary artery disease was visualized. The highly unusual anomalous branch was considered to be an incidental finding, with no pathological contribution to the clinical presentation.