A 42 years old patient complains of chest pain on exertion for last 6 months. TEE shows normal LV with no wall motion abnormalities.
Fisk factors for CKD: obesity, positive family history for CKD.
After the positive stress test patient is referred for coronary angiography.
Beginning of stress test
End of stress test
Due to suspected SCAD patient was hospitalized. Repeated coronary angiography at 2 weeks showed no changes.
IVUS: dissection and intramural haematoma in LAD.
IVUS-guided PCI was done:
DES 3.50×30 mm @ 12atm.
False lumen covered with stent.
Stent optimisation with NC baloon.
ECHO: normal LV with no wall motion abnormalities.
After PCI patient is stable, no chest pain.
Therapy on discharge: ASA, Clopidogrel, b-blocker, ACEi.
Authors: dr Vlada Zdravković, dr Dušan Vulović, dr Đorđe Stevanović, UKC Kragujevac
Would You do PCI without intravascular imaging?