» Articles » PMID: 24683412

Rapid Progression of Nonculprit Coronary Lesions Six Weeks After Successful Primary PCI in Culprit Artery: a Case Report

Overview
Journal J Biomed Res
Specialty General Medicine
Date 2014 Apr 1
PMID 24683412
Authors
Affiliations
Soon will be listed here.
Abstract

We report a case of a 49-year-old man who was admitted with a 3-hour history of sudden onset of substernal chest pain. Coronary angiography revealed that the left circumflex artery (LCX) was acutely and totally occluded at the mid-portion. In addition, the proximal and mid-portion of the right coronary artery (RCA) had a 60% occlusion. We inferred that the LCX was the culprit artery and primary PCI was successfully performed. Six weeks later, the patient had an eventful course with recurrence of chest pain. Coronary angiography showed no significant stenosis in the previous LCX lesion, while the proximal and middle potion of the RCA had a 90% occlusion. Our case demonstrates the systemic nature of acute coronary syndromes and highlights the inherent instability of coronary artery disease.

References
1.
Davies M, Thomas A . Plaque fissuring--the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina. Br Heart J. 1985; 53(4):363-73. PMC: 481773. DOI: 10.1136/hrt.53.4.363. View

2.
Stone G . In search of vulnerable plaque. Circ Cardiovasc Imaging. 2012; 5(4):428-30. DOI: 10.1161/CIRCIMAGING.112.977629. View

3.
Park M, Seung K, Kim P, Park H, Yoon S, Baek J . Long-term percutaneous coronary intervention rates and associated independent predictors for progression of nonintervened nonculprit coronary lesions. Am J Cardiol. 2009; 104(5):648-52. DOI: 10.1016/j.amjcard.2009.04.052. View

4.
Asakura M, Ueda Y, Yamaguchi O, Adachi T, Hirayama A, Hori M . Extensive development of vulnerable plaques as a pan-coronary process in patients with myocardial infarction: an angioscopic study. J Am Coll Cardiol. 2001; 37(5):1284-8. DOI: 10.1016/s0735-1097(01)01135-4. View

5.
Ntalianis A, Sels J, Davidavicius G, Tanaka N, Muller O, Trana C . Fractional flow reserve for the assessment of nonculprit coronary artery stenoses in patients with acute myocardial infarction. JACC Cardiovasc Interv. 2011; 3(12):1274-81. DOI: 10.1016/j.jcin.2010.08.025. View