Identical critical left anterior descending artery stenosis in monozygotic twins

Introduction: Coronary artery disease (CAD) is a multifactorial condition influenced by both genetic predispositions and environmental exposures. Case description: We present a pair of male monozygotic twins diagnosed with identical critical left anterior descending artery stenosis, suggesting a possible hereditary susceptibility involving this coronary segment. One twin presented with acute coronary syndrome while the other was diagnosed with CAD during screening prompted by his sibling’s diagnosis. Conclusion: This report underscores the importance of early screening among genetically related individuals and contributes to the understanding of phenotypic variability in genetically identical patients with CAD.