Coronary artery stenosis - left anterior descending

Case contributed by Stefan Tigges

Presentation

Chest pain after playing tennis.

Patient Data

Age: 50 years
Gender: Female

Normal coronary artery origins with severe stenosis/occlusion LAD distal to the first diagonal origin. No other obstructive lesions.

These 6 selected annotated images show an obstructing lesion in the LAD.

Injection of the left main coronary artery shows severe narrowing of the LAD distal to the origin of a large diagonal branch, findings are otherwise normal.

Annotated Cath Image

Photo

Branches of the left coronary artery are labeled, the stenosis in the LAD is marked with the dashed red oval. 

Case Discussion

Although the CTA findings were suggestive of transient occlusion of the LAD, the catheter angiogram showed that although the vessel was severely narrowed, it was not occluded. The spatial resolution of catheterization is better than that of CTA; CTA often overestimates the degree of vessel narrowing.

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