title: Optical coherence tomography evidence of endothelial erosion as a cause of ST-segment elevation myocardial infarction.
abstract: High-resolution intracoronary imaging provided relevant insights into the field of pathophysiology of acute coronary syndromes (ACS). Human autopsy studies have shown that endothelial erosion may lead to intravascular thrombosis and acute myocardial infarction. We report the case of a 51-year-old woman presenting with ST-segment elevation ACS. In this patient, frequency domain optical coherence tomography (FD-OCT) was performed into the infarct-related artery, showing in-vivo findings suggestive of endothelial erosion, associated with no flow-obstructing luminal thrombus. In this rare case, endothelial erosion, and subsequent thrombosis, in the proximal third of the artery has probably caused embolization and thrombotic occlusion in the mid third. FD-OCT allowed us to obtain a rare in-vivo image of endothelial erosion, providing relevant insights into the setting of ACS.
authors: Department of Cardiovascular Diseases, Division of Interventional Cardiology, University Hospital Santa Maria alle Scotte, Siena, Italy.
authors: Massimo
authors: M
authors: Fineschi
authors: Vasile
authors: V
authors: Sirbu
authors: Flavio
authors: F
authors: D'Ascenzi
authors: Arcangelo
authors: A
authors: Carrera
authors: Riccardo
authors: R
authors: Barbati
authors: Sergio
authors: S
authors: Mondillo
authors: Carlo
authors: C
authors: Pierli
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D041623:Tomography, Optical Coherence