Case

[April 29] CTO LIVE_Severance Hospital, Seoul, Korea: Case #7

- Operator : Kenya Nasu

1st Operator: Kenya Nasu / 2nd Operator: Jung-Hee Lee

Brief Case Summary

55-year-old female patient was referred due to RWMA at LAD territory found during treatment of ischemic stroke.

Past Medical History

  • Previous MI: N
  • Previous CABG : N
  • Previous PCI: N

Demographic Characteristics

  • Diabetes: N
  • Hypertension: Y
  • Hyperlipidemia: N
  • Smoking: N
  • Family History: N
  • Age: 55
  • Sex: Female

Clinical Presentation

Stable angina

Non-invasive Studies

Echocardiography [2018. Jan]

RWMA at akinesia without thinning at anterior and anteroseptal wall of low-mid to apical LV

Cardiac Catheterization Findings

Total occlusion of mLAD (TIMI 0)
Collateral flow from PD, cornus branch of RV to LAD
Ipsilateral collateral flow from diagonal branch to dLAD

Case Notes

Target Lesion(s)

mLAD

Adjunctive Medication

  • ASA: Y
  • LMWH: N
  • Clopidogrel: Y
  • Heparin: N
  • Nitrates: N
  • IIb/IIIa: N
  • Other: Carvedilol SR 8 mg, Losartan 50 mg, atorvastatin 40 mg

Heart CT (2017.10.31)

Coronary angiography (2018.03.15)

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