Figure 1
What finding do you anticipate on coronary angiogram?
A 47-year-old male with a history of dyslipidemia presents to the emergency department with retrosternal chest discomfort. He describes the discomfort as a “tightness,” which began 60 minutes ago while he was watching television. He is unable to specify a location where the discomfort is most prominent, stating that the discomfort is present diffusely throughout his chest, and is associated with nausea, diaphoresis, and difficulty breathing. An ECG demonstrates the findings above. He is given acetylsalicylic acid to chew, however multiple doses of sublingual nitroglycerin do little to relieve his pain. An urgent coronary angiography is requested. What finding do you anticipate on coronary angiogram? Image credit: @akestler.
- Acute occlusion of the proximal left anterior descending (LAD) artery
- Acute occlusion of the left circumflex artery
- Diffuse flow-limiting stenoses in the LAD, circumflex, and right coronary artery (RCA) but no acute occlusion
- No coronary occlusions or flow-limiting stenoses
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