title: Ruptured atherosclerotic plaque distant from maximal stenosis in acute myocardial infarction.
abstract: We describe a patient with acute myocardial infarction who showed ruptured plaque distant from the maximally stenotic lesion. In a 54-year-old male patient with acute antero-lateral myocardial infarction, coronary angiography showed a resolution of occlusive lesion with residual stenotic lesion in the middle portion of the left anterior descending artery (LAD) following t-PA administration. One month later, coronary angiography again disclosed significant stenosis of the middle LAD. Intravascular ultrasound revealed ruptured plaque that was located proximal to the maximally stenotic site which is generally considered as the culprit lesion. In this case, transient vessel occlusion occurred at the maximally stenotic site probably associated with plaque rupture distant from this lesion.
authors.affiliation: Division of Cardiology, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565.
authors.forename: Osamu
authors.initials: O
authors.lastname: Seguchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.forename: Isao
authors.initials: I
authors.lastname: Morii
authors.forename: Yoritaka
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D012422:Rupture, Spontaneous; D013997:Time Factors; D014463:Ultrasonography