PMC6421800_01
Electrocardiogram on admission showed inferior wall ST elevation myocardial infarction. ST elevations in leads II, III, and aVF.
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ST elevations in leads II, III, and aVF consistent with inferior acute myocardial infarction (Figure 1). She was taken emergently to the cardiac catheterization lab where she was noted to have a completely occluded right coronary artery (RCA) (Figure 2).
Coronary angiography with 100% occlusion (arrow) at the midsegment of the right coronary artery from infective endocarditis embolus.
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ST elevations in leads II, III, and aVF consistent with inferior acute myocardial infarction (Figure 1). She was taken emergently to the cardiac catheterization lab where she was noted to have a completely occluded right coronary artery (RCA) (Figure 2).
Coronary angiography after synergy 3.0 x 38 mm drug-eluting stent (arrow) placed in RCA with return of TIMI 3 flow.
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An aspiration was attempted but was unsuccessful, so a 3.0 x 38 mm bioabsorbable drug-eluting stent was placed into the RCA along with balloon dilation of the proximal aspects of the posterior descending artery and distal RCA (Figure 3).
Coronary angiography showing widely patent left main, LAD, and circumflex, without evidence of chronic atherosclerosis.
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Left-sided coronaries were angiographically normal (Figure 4).
Transesophageal echocardiography revealing large aortic vegetation in longitudinal view (arrow).
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These findings were later confirmed with transesophageal echocardiogram, which also identified a patent foramen ovale with continuous right-to-left shunt (Figures 5 and 6).
Transesophageal echo showing patent foramen ovale (arrow).
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These findings were later confirmed with transesophageal echocardiogram, which also identified a patent foramen ovale with continuous right-to-left shunt (Figures 5 and 6).