Author + information
- Received May 6, 2009
- Revision received June 1, 2009
- Accepted June 9, 2009
- Published online April 6, 2010.
A 29-year-old woman presented with recent onset chest pain consistent with pericarditis. A 12-lead electrocardiogram showed minimal ST-segment elevation (A), which normalized in 10 h. Left ventricular function was normal on 2-dimensional echocardiography. A rise in serum troponin was documented, prompting coronary arteriography, which showed a borderline lesion in the distal right coronary artery (B). An intravascular ultrasound exam confirmed a noncritical atherosclerotic lesion (C). Because of the patient's young age and child-bearing status, percutaneous coronary intervention was not pursued. However, a cardiac magnetic resonance imaging adenosine stress perfusion study showed an inferoseptal perfusion defect, and delayed enhancement imaging demonstrated a localized inferoseptal infarction (D), incriminating the right coronary artery lesion as a true “culprit.” On the basis of the cardiac magnetic resonance imaging findings, percutaneous intervention was pursued. The right coronary artery lesion was successfully dilated and stented (E).
- Received May 6, 2009.
- Revision received June 1, 2009.
- Accepted June 9, 2009.
- American College of Cardiology Foundation