case_images: PMC10948477_01
case_images: Electrocardiogram showing extensive anterior wall myocardial infarction.
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case_images: PMC10948477_01_fcvm-11-1355692-g001.jpg
case_images: F1
case_images: The electrocardiogram (MAC800 model, GE Company) revealed an acute, extensive anterior wall myocardial infarction (Figure 1).
case_images: (A) Coronary angiogram showing limited stenosis in the proximal segment of the LAD, up to 95% or more, with antegrade TIMI grade 3; (B) Coronary angiogram showing no significant stenosis in the LCX, with antegrade TIMI grade 3; and (C) Coronary angiogram showing diffuse stenosis from the proximal to the middle and distal segments of the RCA, up to 90% or more, with antegrade TIMI grade 3.
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case_images: F2
case_images: Myocardial Infarction (TIMI) flow grade of 3 (Figure 2A). Meanwhile, the Left Circumflex artery (LCX) showed non-significant stenosis, maintaining a TIMI grade of 3 (Figure 2B). Moreover, diffuse stenosis from the proximal to middle and distal segments of the Right Coronary Artery (RCA) was noted, along with greater than 90% stenosis, preserving a TIMI grade 3 flow (Figure 2C).
case_images: (A) Coronary angiography shows proximal occlusion of the LAD, stenosis of the OM and LCX, and diffuse stenosis of the RCA throughout, with occlusion of the distal segments. (B) Stenosis is relieved by intracoronary injection of nitroglycerin. (C) Stenosis of the RCA is markedly improved by administration of nitroglycerin for half a minute.
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case_images: F3
case_images: Re-evaluation angiography revealed proximal LAD occlusion, stenosis of the Obtuse Marginal artery (OM) and LCX, and diffuse RCA stenosis with distal segment occlusion (Figure 3A). At the same time, continuous and large amounts of intracoronary nitroglycerin was given, after which the patient's symptoms gradually subsided, stenosis improved (Figure 3B), and RCA stenosis improved significantly after half a minute of nitroglycerin administration (Figure 3C).
case_images: Coronary angiogram showing no residual stenosis after placement of 1 stent in the proximal segment of the LAD with anterograde flow TIMI grade 3.
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case_images: F4
case_images: Following a mid-segment LAD stent implantation, blood flow was restored (Figure 4).