alexa Coronary Angiography, Too Far to be a Gold Standard Technique for Identifying a Vulnerable Plaque | OMICS International | Abstract
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
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Case Report

Coronary Angiography, Too Far to be a Gold Standard Technique for Identifying a Vulnerable Plaque

Gema Minana*, Julio Nunez and Juan Sanchis
Servicio de Cardiologia, Hospital Clínico Universitario de Valencia, Valencia, Spain
Corresponding Author : Gema Minana
Servicio de Cardiología. Hospital Clínico Universitario Valencia Avda
Blasco Ibanez 17. 46010 Valencia, Spain
Tel: 34 96 3862658
Fax: 34 96 3862658
E-mail: [email protected]
Received March 07, 2011; Accepted April 04, 2011; Published April 05, 2011
Citation: Minana G, Nunez J, Sanchis J (2011) Coronary Angiography, Too Far to be a Gold Standard Technique for Identifying a Vulnerable Plaque. J Clinic Experiment Cardiol 2:132. doi: 10.4172/2155-9880.1000132
Copyright: © 2011 Minana G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

A 79 year-old woman with symptomatic heart failure and severe aortic stenosis was referred to a routine diagnostic coronary angiography previous to surgical aortic valve replacement. Coronary angiography showed severe stenosis in the left circumflex artery and in the ostium of the posterior descending artery. Four days later the patient presented an inferior ST-segment elevation acute coronary syndrome with cardiogenic shock. A rescue angioplasty was performed after failed thrombolysis. Coronary angiography revealed no changes in left coronary artery and a total acute occlusion in the middle segment of the right coronary artery, where only a mild lesion was observed four days before. A rescue angioplasty with a bare-metal stent implantation was performed with an optimal angiographic result. This case highlights the low ability of the conventional x-ray coronary angiography to identify vulnerable plaques. Even knowing the coronary anatomy four days before, we were unable to predict the culprit lesion.

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