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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| Format: | Article |
| Language: | English |
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American College of Physicians
2023-07-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2023.0224 |
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| _version_ | 1849698749009362944 |
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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. |
| format | Article |
| id | doaj-art-154ac1974c8a4697bdbc8360be67a61e |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | American College of Physicians |
| record_format | Article |
| 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 |