PMC5643090_01
Left heart catheterization identifying stenosis of proximal right coronary artery.
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ST segment elevations in augmented vector foot (avf) and limb lead III (L-III) with increased serum cardiac enzymes. She was emergently taken to the catheterization lab and was found to have a 95% stenosis in the proximal right coronary artery (RCA) (Figure 1), a 60% stenosis in the diagonal 1 branch, and a 75% stenosis in middle left anterior descending artery (mLAD) lesion.
Post-CABG EKG showing ST segment elevations in L-II, L-III, aVF, and V3-V6.
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ST segment elevations in the inferior and anterolateral leads (Figure 2). She was however symptom free and these were thought to be postoperative changes.
Left heart catheterization showing occlusion of SVG graft to RPDA.
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Repeat catheterization showed occlusion of SVG graft to RPDA (Figure 3), thrombosis of the LAD distal to the LIMA insertion (Figure 4), and thrombosis of the RPDA (Figure 5).
Left heart catheterization showing diseased LAD distal to LIMA insertion.
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Repeat catheterization showed occlusion of SVG graft to RPDA (Figure 3), thrombosis of the LAD distal to the LIMA insertion (Figure 4), and thrombosis of the RPDA (Figure 5).
Left heart catheterization identifying worsening disease of RPDA after CABG.
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Repeat catheterization showed occlusion of SVG graft to RPDA (Figure 3), thrombosis of the LAD distal to the LIMA insertion (Figure 4), and thrombosis of the RPDA (Figure 5).