Maksymilian P. Opolski et al. Kajetan Grodecki Mateusz Spiewak Mariusz Furmanek Ilona Michalowska
A 45-year-old male without past medical history presented with retrosternal chest pain and ST-segment elevation in inferolateral leads at ECG. Invasive coronary angiography, along with optical coherence tomography performed as part of the clinical study, showed normal coronaries, and myocardial infarction with non-obstructive coronary arteries (MINOCA) was diagnosed (-). Due to ongoing chest pain, triple-rule-out computed tomography angiography (CTA) was undertaken to exclude aortic dissection and pulmonary embolism. Incidentally, anomalous left circumflex artery (LCx) originating from the right sinus of Valsalva with a suspicion on severe stenosis was detected (-). Selective angiography of the LCx confirmed severe lesion in the distal vessel segment (), however given the resolution of patient’s symptoms, a decision on medical therapy with dual antiplatelet agents was undertaken. At discharge, cardiac magnetic resonance disclosed mildly reduced left ventricular ejection fraction (53%) with myocardial edema and transmural infarction of the basal-to-mid lateral wall (-).
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