Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report

The patient is a 59-year-old man who presented with substernal chest pain. Electrocardiogram showed evidence of inferior ST-segment elevation, and his troponin I level peaked at 40 µg/L. Coronary angiogram showed a severely ectatic right coronary artery with near-total acute thrombotic occlusion of...

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Main Authors: Toluwalase Awoyemi, Tim Provias
Format: Article
Language:English
Published: American College of Physicians 2023-07-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.0224
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author Toluwalase Awoyemi
Tim Provias
author_facet Toluwalase Awoyemi
Tim Provias
author_sort Toluwalase Awoyemi
collection DOAJ
description The patient is a 59-year-old man who presented with substernal chest pain. Electrocardiogram showed evidence of inferior ST-segment elevation, and his troponin I level peaked at 40 µg/L. Coronary angiogram showed a severely ectatic right coronary artery with near-total acute thrombotic occlusion of the distal right coronary artery and total acute thrombotic occlusion of the distal posterior descending artery. He had a successful intravascular ultrasound-guided aspiration thrombectomy with a penumbra and intracoronary tissue plasminogen activator infusion. This case highlights an alternative way of treating acute thrombotic occlusion of ectatic arteries asides from the conventional but challenging practice of coronary revascularization with stent placement.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-154ac1974c8a4697bdbc8360be67a61e2025-08-20T03:18:49ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642023-07-012710.7326/aimcc.2023.0224Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case ReportToluwalase Awoyemi0Tim Provias11Department of Internal Medicine, Northwestern Memorial Hospital, Chicago, Illinois2Northwestern Medicine Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Chicago, IllinoisThe patient is a 59-year-old man who presented with substernal chest pain. Electrocardiogram showed evidence of inferior ST-segment elevation, and his troponin I level peaked at 40 µg/L. Coronary angiogram showed a severely ectatic right coronary artery with near-total acute thrombotic occlusion of the distal right coronary artery and total acute thrombotic occlusion of the distal posterior descending artery. He had a successful intravascular ultrasound-guided aspiration thrombectomy with a penumbra and intracoronary tissue plasminogen activator infusion. This case highlights an alternative way of treating acute thrombotic occlusion of ectatic arteries asides from the conventional but challenging practice of coronary revascularization with stent placement.https://www.acpjournals.org/doi/10.7326/aimcc.2023.0224
spellingShingle Toluwalase Awoyemi
Tim Provias
Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report
Annals of Internal Medicine: Clinical Cases
title Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report
title_full Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report
title_fullStr Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report
title_full_unstemmed Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report
title_short Right Coronary Artery Ectasia Manifesting With Acute Coronary Syndrome and Atrial Fibrillation: A Case Report
title_sort right coronary artery ectasia manifesting with acute coronary syndrome and atrial fibrillation a case report
url https://www.acpjournals.org/doi/10.7326/aimcc.2023.0224
work_keys_str_mv AT toluwalaseawoyemi rightcoronaryarteryectasiamanifestingwithacutecoronarysyndromeandatrialfibrillationacasereport
AT timprovias rightcoronaryarteryectasiamanifestingwithacutecoronarysyndromeandatrialfibrillationacasereport