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Case 270.
Mario Sutil-Vega1, Daniel Romeu Vilar1, Antonio J Barros-Membrilla1
1From the Cardiac Imaging Unit (M.S.V., G.P.L.), Aortic Disease Unit (A.J.B.M.), and Interventional Cardiology Unit (X.M.), Department of Cardiology, and Department of Radiology (J.A.H.), Hospital de la Santa Creu i Sant Pau-UAB, C/Mas Casanovas 90, 08041 Barcelona, Spain; and Department of Radiology, Complejo Hospitalario Universitario A Coruña, La Coruña, Spain (D.R.V.).
A 54-year-old woman experienced chest pain and was diagnosed with ST-segment elevation myocardial infarction. Coronary angiography revealed significant blockages, leading to stent placement and successful treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diagnostic Imaging
Background:
- A 54-year-old woman presented with acute chest pain during physical exertion.
- She had a history of hypertension but no other cardiovascular risk factors or family history of ischemic heart disease.
- Initial presentation mimicked a typical acute coronary syndrome.
Purpose of the Study:
- To investigate the cause of ST-segment elevation myocardial infarction (STEMI) in a patient without traditional risk factors.
- To detail the diagnostic and interventional procedures performed.
- To highlight the importance of comprehensive vascular imaging in atypical presentations.
Main Methods:
- Electrocardiography (ECG) for initial diagnosis.
- Emergent coronary angiography with intravascular ultrasound (IVUS) to visualize coronary arteries.
- Percutaneous coronary intervention (PCI) with stent placement.
- ECG-synchronized CT angiography for further vascular assessment.
Main Results:
- ECG confirmed anterior STEMI.
- Coronary angiography revealed significant stenosis in the left anterior descending and left circumflex arteries.
- Successful angioplasty and stent placement were performed.
- CT angiography provided a comprehensive view of the arterial system.
Conclusions:
- This case highlights a rare presentation of myocardial infarction in a patient with atypical risk factors.
- Prompt diagnosis and intervention were crucial for successful management.
- Advanced imaging modalities aid in understanding complex cardiovascular events.
