case_images: PMC4493291_01
case_images: Initial ECG showing ST elevations in V2-V5, II, III, and AVF which are consistent with anterolateral and inferior STEMI.
case_images: CRIM2015-390642.001.jpg
case_images: PMC4493291_01_CRIM2015-390642.001.jpg
case_images: fig1
case_images: ST segment elevations (Figure 1). She received Aspirin 325 mg, Clopidogrel 600 mg, and Heparin 5000 U in the ED and was sent for emergent cardiac catheterization.
case_images: Cardiac catheterization demonstrating severe mid to distal LAD occlusion.
case_images: CRIM2015-390642.002.jpg
case_images: PMC4493291_01_CRIM2015-390642.002.jpg
case_images: fig2
case_images: She was found to have a long, tortuous 99% mid and distal left anterior descending (LAD) lesion with Grade I flow (Figure 2).
case_images: Cardiac catheterization after stent placement showing return of the blood flow in the LAD territory.
case_images: CRIM2015-390642.003.jpg
case_images: PMC4493291_01_CRIM2015-390642.003.jpg
case_images: fig3
case_images: Thrombolysis in Myocardial Infarction (TIMI) III Grade flow restored (Figure 3). The right and left circumflex coronary vessels were angiographically normal.
case_images: EKG after showing resolution of STE now shows new STE in V3-V4 while the patient was complaining of recurrent CP approximately 15 hours after cardiac catheterization.
case_images: CRIM2015-390642.004.jpg
case_images: PMC4493291_01_CRIM2015-390642.004.jpg
case_images: fig4
case_images: STE in ECG leads V2-V5 (Figure 4). She was started on Heparin and Abciximab.
case_images: After second intervention cardiac catheterization showed distal LAD stent thrombosis with TIMI Grade 0 flow.
case_images: CRIM2015-390642.005.jpg
case_images: PMC4493291_01_CRIM2015-390642.005.jpg
case_images: fig5
case_images: The mid LAD stent was patent, but there was 100% thrombosis of the distal LAD stents (Figure 5).