Can someone help me with vessel identification? Anamolous LM from Rt aortic sinus. However, I was unable to identify LAD and LCX. Which one is LAD?

Vestigial LAD. The PDA is the wrap around the apex vessel.

Is there a LAO 90 (lateral view) to confirm LAD going to apex?

Single coronary artery, The rest is compensatory local anatomy, good luck in finding which is what. The" God rule": total embryonic tissue mass, is fixed, what is absent from one part, is taken by the other.

By definition, the “LAD” is the artery lying in the anterior inter ventricular groove. That’s why they named it LAD. Most LADs have a distinct appearance.Some don’t, including this one. In this case the classic “LAD” is mostly supplied by the RPDA

There is no LAD i guess. Circ giving large multiple OMs. RCA super dominant supplier to IVS

Prepulmonic LMT usually goes to mid lad. Red lines are lad. Yellow is LCX. Apex supplied by distal rpda.

I would confirm with a CT coronary angio, but rightly said as RPDA seems wrapping around LV apex, but usually there is a small LAD even from left sinus with intramyocardial course, something akin to type IV dual LAD

Sir i once posted exact same case but with anamolous origin from left cusp..please have a look at this

It’s LCX from right sinus , left sinus only isolated lad coming , u can also suspect this by seeing very long LM

The 1st branches of long LMS are septals. It then divides into vessel that gives the lateral wall branches (in LAO cran these run off to the right of the image) and a vessel that continues to run in the anterior IV groove which is small LAD(runs down middle of image in LAO cran)