PMC9402264_01
Emergency electrocardiogram in August 2011.
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F1
An electrocardiogram showed ST-segment elevation in I, II, III, AVF, and V2-V6 (Figure 1), and cardiac enzyme levels were increased, so he was considered as STEMI. An emergency coronary angiography showed a long dissection and thrombus shadow since the diagonal branch in the left anterior descending branch (LAD) (Figure 2A), while the left main artery (LM), left circumflex branch (LCX), and right coronary artery (RCA) showed no abnormalities, and SCAD was diagnosed.
(A) Coronary angiography suggests spontaneous coronary artery entrapment (red arrow) and thrombotic shadow (white arrow) in LAD. (B) After implantation of 1 stent at the entrapment.
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F2
An electrocardiogram showed ST-segment elevation in I, II, III, AVF, and V2-V6 (Figure 1), and cardiac enzyme levels were increased, so he was considered as STEMI. An emergency coronary angiography showed a long dissection and thrombus shadow since the diagonal branch in the left anterior descending branch (LAD) (Figure 2A), while the left main artery (LM), left circumflex branch (LCX), and right coronary artery (RCA) showed no abnormalities, and SCAD was diagnosed. Beijing, China, LOT:201103001) was implanted at the LAD lesion (Figure 2B).
PMC9402264_02
PMC9402264_03
Emergency electrocardiogram in July 2021.
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F3
Electrocardiogram returned to normal (Figure 3), and computed tomography angiography (CTA) that was performed on this admission suggested: (1) Severe stenosis at the proximal end of the LAD stent and moderate stenosis at the distal end of the stent. (2) Moderate stenosis at the proximal segment of the RCA; severe stenosis at the middle segment; and moderate stenosis at the distal segment.
(A) LAD 100% occlusion (red arrow). (B) RCA with two stenoses (red and white arrows). (C) LAD after implantation of 3 drug balloons. (D) RCA after implantation of 1 stent and 1 drug balloon.
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F4
The patient was admitted for coronary arteriography, which showed there was 100% occlusion of the LAD from the stent and the collateral circulation was provided by the acute marginal artery (AM) (Figure 4A); there was 40% stenosis of the middle LCX; there was 80% localized stenosis in the middle RCA1 segment and 90% localized stenosis at RCA2 segment (Figure 4B). Henan, China, LOT:06200611A1) were placed at the RCA, thus promoting the establishment of collateral circulation (Figure 4D). Henan, China, LOT:06210817A1, 06210621A1, 06210626A1) were placed (Figure 4C).