A patient came back with retrograde coronary flow in the distal right coronary artery 2 years after coronary intervention: clinical significance of retrograde coronary flow to detect coronary artery occlusion.
A 69-year-old male patient, who had a history of coronary stent implantation to the proximal right coronary artery (RCA), presented with exertional chest pain. Transthoracic Doppler echocardiography revealed retrograde coronary flow in the distal RCA, and treadmill stress echocardiography revealed inducible myocardial ischemia in the inferior and posterior segments. Coronary angiography demonstrated a severe stenotic lesion with flow delay in the mid RCA and collateral circulation to the distal RCA from the left coronary artery. Detection of retrograde coronary flow in the distal RCA using transthoracic Doppler echocardiography is a useful method to diagnose subtotal occlusion of the RCA.
Takagi Cardiology Clinic, Mibu Kayogosho-cho 3-3, Nakagyo-ku, Kyoto, 604-8811, Japan. tcardiol@qb4.so-net.ne.jp.
Tsutomu
T
Takagi
Coronary artery disease; Coronary artery flow; Retrograde coronary flow; Transthoracic Doppler echocardiography