The LAD medical abbreviation usually refers to the left anterior descending artery, the large vessel that runs down the front of the heart and feeds much of the left ventricle. It appears in heart catheter reports, bypass surgery notes, stent records and echo reports.
LAD has two other common uses. On an EKG reading it can mean left axis deviation, and in a physical exam it is sometimes used for lymphadenopathy, meaning swollen lymph nodes. The rest of this page covers each meaning, decodes common phrases such as LIMA to LAD and DES to LAD, and shows how to tell them apart.
At a glance
Stands for
Left anterior descending (coronary) arteryOther meanings
Left axis deviation (EKG); lymphadenopathy (exam)Branch of
The left main coronary arterySupplies
Front wall of the left ventricle and much of the septumSpecialty
Cardiology, cardiac surgery, internal medicineCommon phrases
LIMA to LAD, DES to LAD, PCI to LAD, mid LAD
The LAD medical abbreviation in heart care
The heart has its own blood supply. The left main coronary artery splits into the LAD and the circumflex artery, and the right coronary artery runs on the other side. The LAD travels in a groove down the front of the heart toward the tip and sends off diagonal branches and septal branches along the way.
Reports describe the LAD in segments: proximal, mid and distal. A blockage near the start of the LAD can affect a large area of heart muscle, which is why cardiologists pay close attention to it. Narrowing here is a feature of coronary artery disease.
LIMA to LAD, DES to LAD and PCI to LAD
These short phrases describe how a narrowed LAD was treated. Each pairs a procedure with the vessel.
| Phrase | What it means |
|---|---|
| LIMA to LAD | A bypass graft using the left internal mammary artery, sewn onto the LAD during CABG |
| DES to LAD | A drug-eluting stent placed in the LAD |
| PCI to LAD | Percutaneous coronary intervention, opening the LAD through a catheter, often with a stent |
| CTO of LAD | A chronic total occlusion, a long-standing complete blockage |
The LIMA to LAD graft is the most common graft in bypass surgery, and it has a strong record of staying open over the long term. You may also see LITA, for left internal thoracic artery, which is another name for the same vessel.
A cath report line, decoded
Catheterization summary: "90% proximal LAD stenosis. Successful PCI with DES x1 to proximal LAD. TIMI 3 flow restored." This means the first part of the artery was narrowed by about ninety percent, one drug-eluting stent was placed, and blood now flows normally past the treated spot.
Discharge papers after a stent often add medicines to help keep the stent open. Questions about those belong with the cardiology team or pharmacist.
Left axis deviation on an EKG
On an electrocardiogram reading, LAD can mean left axis deviation. The electrical axis describes the overall direction the heart's signal travels. When it points further left than usual, the reader writes left axis deviation. Causes include a block in part of the left bundle branch, thickening of the left ventricle and some congenital patterns. It can also be seen in healthy people.
The clue is the setting: an EKG interpretation, often near other terms such as sinus rhythm, rate and intervals.
LAD for lymphadenopathy
In exam notes, some clinicians write LAD for lymphadenopathy, meaning enlarged or swollen lymph nodes. A note might read "no cervical LAD" to say the neck nodes were not swollen. Others write LN or LAN instead.
| Meaning | Typical setting | Example wording |
|---|---|---|
| Left anterior descending artery | Cath lab, cardiac surgery, echo | Mid LAD 70%, LIMA to LAD |
| Left axis deviation | EKG reading | NSR, rate 72, LAD |
| Lymphadenopathy | Physical exam, infection or cancer workup | Neck supple, no LAD |
When the setting gives no clue, the author of the note can say which one was meant.
For students and scribes
When charting, place the vessel name after the procedure, as in stent to mid LAD. Avoid using LAD for swollen nodes in a cardiac note, where it would be read as the artery. The tests and scans abbreviation section gathers related cardiac and imaging shorthand.
These are general explanations of how LAD is written. Your cardiologist or the clinician who wrote your report can explain what it means for your own heart or exam.
Frequently asked questions
What does LAD mean in a heart report?
It means the left anterior descending artery, one of the main coronary arteries. Reports often say where along the artery a narrowing sits, such as proximal or mid LAD.
What does LIMA to LAD mean?
It means a bypass graft from the left internal mammary artery, a chest wall artery, was attached to the LAD past the blockage. It is the most common graft used in coronary bypass surgery.
What does LAD mean on a physical exam?
In exam notes LAD usually means lymphadenopathy, or swollen lymph nodes. A phrase like no LAD means the nodes felt normal.
Why is the LAD sometimes called the widow maker?
That is an informal nickname for a severe blockage near the start of the LAD, because it supplies a large part of the heart. Clinicians rarely write it in formal notes.