Female 62y. old hospitalized in a regional hospital as NSTEMI.
Presented on September 23. with chest pain. ECG showed SVT with ST-segment depression. Baseline troponin level 1.8 (ref. value <0.04).
Risk factors for CVD: hypertension, obesity (BMI 36), positive family history of CVD
Referred for elective coronarography on December 1.
ECG:
Coronarography:
ECHO:
Coronarography was presented to 8 interventional cardiologists for interpretation.
Answers:
SCAD: 5
Bridge: 1
SCAD+Bridge: 2
Due to the lack of an OCT catheter the patient was referred to CTA.
CTA: calcified plaque in proximal LAD with 25% stenosis 20mm from ostium. Medial LAD is very thin with loss of opacification at 50mm from ostium.
Control coronarography was done on December 23, with a plan to do OCT.
After NTG administration.
Initially planned OCT was not done.
Questions:
Do you agree with the myocardial bridge as a diagnosis?
Would you do an OCT after the administration of NTG?
What are possible adverse events in OCT imaging of the coronary artery with a myocardial bride?
Coexistence of Spontaneous Coronary Artery Dissection, Takotsubo Cardiomyopathy, and Myocardial Bridge:
