Presentation
Chest pain.
Patient Data
CORONARY ANATOMY: The coronary arteries arise in a normal position. Co-dominant circulation: the right coronary supplies the posterior descending artery, the circumflex supplies a posterior left ventricular branch.
CORONARY CT ANGIOGRAM:
Left main: the left main coronary artery bifurcates into the LAD and CX; atherosclerotic plaque with minimal stenosis (1-24%)
Left anterior descending: atherosclerotic plaque with occlusion of D1 (100%), severe stenosis (70-99%) of the midsegment, and moderate stenosis (50-69%) of the distal segment
Left circumflex: plaque and/or stenosis: atherosclerotic plaque with mild stenosis (25-49%)
Ramus intermedius branch: occluded.
Right coronary artery: atherosclerotic plaque which is occlusive (100% stenosis) along the proximal segment, with distal reconstitution
Case Discussion
A nice example of multi-vessel coronary artery disease.
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