Stepping into the Light: Defining Culprit Lesion in Non-ST Elevation Myocardial Infarction.

Figures

• 

  Fig. 1. (a) Documented ventricular tachycardia at first contact ECG with rate of 280 bpm. The ECG showed inferior lead discordance negative axis lead II, positive axis at lead III. R/S ratio at V6 < 1 suggestive for anterolateral papilary muscle (APM) origin (b) Documented supraventricular tachycardia short RP with rate was 150 bpm.

• 

  Fig. 2. Post-converted ECG with Normal sinus rhythm 75 bpm, normoaxis with T wave flattening/depressed at I, aVL, V6.

• 

  Fig. 3. Corongiography (a) right coronary artery (RCA): stenosis 50% at proximal, stenosis 70% at mid (b) and (c) left main (LM): normal, left anterior descenden (LAD): stenosis 70% at proximal to mid, left circumflex (LCx): subtotal occlusion at proximal, TIMI Thrombus Grade IV, TIMI 1–2 Flow (White Arrow).

• 

  Fig. 4. Coroangiography of LCx after intervention of thrombus aspiration and eptifibatide intracoronary administration showing improvement of coronary flow and small residual thrombus.

• 

  Fig. 5. Schematic figure and algorithm to predict the site origin of ventricular tachycardia (Source: Enriquez et al., 2019; Muser et al., 2021).