> Cases

1st Operator: Seung-Whan Lee / 2nd Operator: Chang Hoon Lee / 3th Operator: Gyeong-Min Park

Brief Case Summary

A 57 year-old male was admitted for the evaluation of coronary CT angiography abnormality. The coronary angiography was performed which revealed significant stenosis at proximal to mid LAD and total occlusion at proximal RCA. Then, proximal to mid LAD lesion was stent implanted.

Past Medical History

  • Previous MI: N
  • Previous CABG : N
  • Previous PCI: Y
  • Other: h/o CVA, current smoker

Demographic Characteristics

  • Diabetes: Y
  • Hypertension: N
  • Hyperlipidemia: N
  • Smoking: Y
  • Family History: N
  • Age: 57
  • Sex: Male
  • Other: h/o CVA

Clinical Presentation

Silent ischemia

Non-invasive Studies


Akinesia of inferoposterior wall with normal LV systolic function (EF 54%)

Treadmill test


Thallium SPECT

Not done

Cardiac Catheterization Findings

  • The coronary angiography showed total occlusion at proximal RCA with grade 3 collateral flow from OM.
  • Significant stenosis of proximal to mid LAD was also shown.
  • SYNTAX score: 28

Case Notes

Target Lesion(s)

Proximal RCA

Adjunctive Medication

  • ASA: Y
  • LMWH: N
  • Clopidogrel: Y
  • Heparin: N
  • Nitrates: N
  • IIb/IIIa: N
  • Other: Beta-blocker, statin

Teaching Points

  • Anterograde or retrograde approach of total occlusion of RCA

Coronary Angiography

Sign in to leave a comment.
CardioVascular Research Foundation (CVRF)
2nd Floor, Asan Institute for Education & Research, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
Tel_82.2.3010.4792 | Fax_82.2.475.6898
ǥ̻ ڽ | ı øȷ43 88, ƻ꺴 ƻ걳 2 | ڵϹȣ 215-82-06387
å_ | ȭȣ_02.3010.4792 | ѽȣ_02.475.6898
Copyright © CVRF, Seoul, Korea. All rights reserved.