The two main coronary trees
The coronary circulation begins at the aortic root with the left and right coronary arteries. The left main artery quickly divides into the left anterior descending (LAD), which runs down the front of the heart and gives off diagonal branches, and the left circumflex (LCx), which wraps around the left side giving obtuse marginal (OM) branches.
The right coronary artery (RCA) supplies the right side and, in most people, continues as the posterior descending artery (PDA) supplying the inferior wall.
What dominance means on angiography
Coronary dominance refers to which artery gives rise to the PDA. Right dominance is most common, left dominance and codominance are less frequent. This pattern shapes which territory is affected when a given vessel is blocked.
Angiographic anatomy guides decisions about stenting or bypass, but reading and acting on a catheterization study is the work of an interventional cardiology team. This is general educational information, not medical advice.