PMC7399019_01
ECG on admission demonstrating anterior ST-segment elevation.
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F1
After the pain worsened over 2 h, the patient called for an ambulance and an electrocardiogram (ECG) revealed significant anterior ST elevation (see Figure 1). The left anterior descending artery (LAD) had good antegrade flow with only mild disease in the mid-vessel (Figures 2A-D, Video S1).
Diagnostic coronary angiography of left coronary artery system (A-D) and RCA (E,F) Views: (A,B) PA cranial; (C) PA caudal; (D) LAO Caudal; (E) LAO; (F) RAO.
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F2
The left anterior descending artery (LAD) had good antegrade flow with only mild disease in the mid-vessel (Figures 2A-D, Video S1). Right coronary angiography revealed a recessive vessel with occlusion of the right ventricular (RV) branch at the ostium (Figures 2E,F, 3A,C).
Views of the RCA before (A,C) and after (B,D) drug eluting balloon treatment. Markers indicate the RV branch which was occluded and subsequently recanalized following intervention.
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F3
Right coronary angiography revealed a recessive vessel with occlusion of the right ventricular (RV) branch at the ostium (Figures 2E,F, 3A,C). The ostial lesion was treated with an IN.PACT Falcon 2.0 mm x 20 mm Falcon drug eluting balloon resulting in resolution of the chest pain and normalization of the ST segments (Figures 3B,D).