Left main divides into two. Some times into three . Very rarely into 4
Look at this angiogram , This looks like a quadrification, if not quadrification equivalent
Clinical implication
A 4 way division invariably means the OM and diagonal or going to be diminutive.These people are expected to have favorable coronary hemodynamics during ACS , and left main lesions are less likely to occur
Reference
This article is from Singapore medical Journal
Dr.S.Venkatesan MD 
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