Double Culprit Lesions in a Patient With ST-Segment Elevation Myocardial Infarction

Figures

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  Figure 1. Electrocardiogram at Presentation Initial electrocardiogram shows an extensive anterior and inferior ST-segment elevation.

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  Figure 2. Left Coronary Artery Left coronary artery before (A) and after (B) medical therapy. Initial left coronary angiogram: the red circle shows a large thrombus in the proximal left anterior descending artery (LAD) (1) with distal occlusions of the LAD (2) and the first diagonal branch (3). Day 4 left coronary angiogram shows complete resolution of proximal LAD thrombus and restored flow in distal artery.

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  Figure 3. Right Coronary Artery Right coronary artery before (A) and after (B) medical therapy. Initial right coronary angiogram: the red circle shows a large thrombus in the mid-right coronary artery (RCA) (1) with distal occlusion of a posterolateral branch (2). Day 4 right coronary angiogram shows complete resolution of mid-RCA thrombus and restored flow in posterolateral branch.

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  Figure 4. OCT Imaging of LAD Optical coherence tomography (OCT) imaging shows the proximal left anterior descending artery (LAD) lumen with the guidewire (1), the OCT lens (2) and a plaque erosion with nonocclusive thrombus adherent to the vessel wall (3).

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  Figure 5. OCT Imaging of RCA OCT imaging shows the mid-RCA lumen with the guidewire (1), the OCT lens (2), and a plaque erosion with nonocclusive thrombus adherent to the vessel wall (3). Abbreviations as in Figures 3 and 4.