To investigate the feasibility of noninvasive detection of the left anterior descending intramural coronary artery by transthoracic echocardiography and the characteristics of Doppler flow spectrum.

A total of 43 patients with intramural coronary artery diagnosed by angiography or computed tomography angiography received echocardiography at the First Affiliated Hospital of Xi 'an Medical College from June 1, 2021 to December 1, 2023 were selected. The diagnosis of intramural coronary artery was based on the curving of coronary artery blood flow with an acceleration blood flow signal during diastolic, and its spectrum of Doppler blood flow was measured.

Echocardiography detected 32 left anterior descending intramural coronary artery, with the detection rate of 74.42%, including 3 in proximal left anterior descending branch, 25 in middle left anterior descending branch, and 4 in distal left anterior descending branch. All 32 patients had a "fingertip-like" Doppler’ blood flow spectrum in early diastole, with 9 patients had a "platform-like" in middle and late diastole, 5 patients had a "reverse" in systole, and 3 patients had an thickened and atherosclerotic changed wall of intramural coronary artery. The display rate of the left main coronary artery by transthoracic echocardiography in the examination of coronary artery plaque was 100.00%. The display rates of the proximal, middle, and distal anterior descending branch were 100.00%, 75.00%, and 6.25%, respectively; and the display rates of the proximal, middle, and distal right coronary artery were 61.54%, 16.67%, and 40.00%, respectively.

Echocardiography could non-invasively detect left anterior descending intramural coronary artery, and the curving of coronary artery blood flow with an "fingertip-like" Doppler’ blood flow spectrum in early diastole maybe the characteristic change.