Premature Coronary Artery Disease in a Young Female Patient With High Lipoprotein(a)

Figures

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  Figure 1. Initial Coronary Angiography (A) RAO caudal view. (B) RAO cranial view. Coronary angiography demonstrating chronic total occlusions of the distal left anterior descending artery and firstobtuse marginal branch, severe stenosis of the proximal left circumflex artery, and diffuse moderate disease throughout the left anterior descending artery. RAO = right anterior oblique.

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  Figure 2. Coronary Angiogram After Stenting, RAO Caudal View RAO caudal view after successful percutaneous coronary intervention demonstrating drug-eluting stent placement in the proximal and mid left anterior descending artery, recanalization of the chronic total occlusion in the apical left anterior descending artery, and stenting of the left circumflex artery. RAO = right anterior oblique.

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  Figure 3. Myocardial Perfusion Imaging Report Myocardial perfusion imaging demonstrating a fixed mild perfusion defect in the apical and midanterior segments at both stress and rest, without evidence of inducible ischemia. VLA = vertical long-axis.

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  Figure 4. Repeat Coronary Angiogram, RAO Caudal View RAO caudal view from repeat coronary angiography demonstrating disease progression, with occlusion of the distal left anterior descending artery stent and in-stent restenosis of the proximal left circumflex artery. RAO = right anterior oblique.

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  Visual Summary. Clinical Timeline Illustrating Disease Progression, Alongside the Molecular Structure of Lipoprotein(a) CAD = coronary artery disease; LDL-C = low-density lipoprotein cholesterol; Lp(a) = lipoprotein(a); PCI = percutaneous coronary intervention.