title: Rapid progression of nonculprit coronary lesions six weeks after successful primary PCI in culprit artery: a case report.
abstract: We report a case of a 49-year-old man who was admitted with a 3-hour history of sudden onset of substernal chest pain. Coronary angiography revealed that the left circumflex artery (LCX) was acutely and totally occluded at the mid-portion. In addition, the proximal and mid-portion of the right coronary artery (RCA) had a 60% occlusion. We inferred that the LCX was the culprit artery and primary PCI was successfully performed. Six weeks later, the patient had an eventful course with recurrence of chest pain. Coronary angiography showed no significant stenosis in the previous LCX lesion, while the proximal and middle potion of the RCA had a 90% occlusion. Our case demonstrates the systemic nature of acute coronary syndromes and highlights the inherent instability of coronary artery disease.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China; ; Division of Cardiology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Wuxi, Jiangsu 214400, China;
authors.forename: Jianjin
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China;
authors.forename: Zemu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China;
authors.forename: Dingguo
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China;
authors.forename: Liansheng
authors.initials: L
authors.lastname: Wang
keywords: acute coronary syndrome; nonculprit coronary lesions; percutaneous coronary intervention