Ruptured atherosclerotic plaque distant from maximal stenosis in acute myocardial infarction.
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.
Seguchi
Osamu
O
Division of Cardiology, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565.
Maehara
Akiko
A
Morii
Isao
I
Otsuka
Yoritaka
Y
Yasuda
Satoshi
S
Miyazaki
Shunichi
S
Yamagishi
Masakazu
M
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