A 41-year-old man developed persistent angina pectoris following blunt trauma to his chest. Three months after the injury coronary angiography demonstrated 80% obstruction of the mid-left anterior descending coronary artery. There was no evidence of atherosclerosis in the remaining coronary arteries. Therefore the assumption is made that blunt trauma can induce incomplete coronary occlusion resulting in classic angina pectoris in apparently otherwise normal coronary arteries. The suggested mechanism of injury to the coronary vessel is either intimal tear and/or subintimal hemorrhage with incomplete luminal thrombosis.
We describe an approach for rapid visualization of the right coronary artery (RCA) with an anterior-inferior ostium. The success rate of this method has been 100% without any complications. It decreases patient discomfort, reduces radiation exposure, and increases safety by decreasing procedure time.
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