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The only alternative is old inferior MI with persistent ST-Elevation, or inferior aneurysm morphology. Inferior Aneurysm morphology is incredibly hard to differentiate from Acute OMI, but you should suspect it whenever there are well-formed inferior Q-waves. Unlike anterior aneurysm, a QS-wave is uncommon.
Introduction:Sinus of Valsalva aneurysm (SVA) accounts for 3.5% Her heart failure was due to the fistula as she had no coronary artery disease on coronaryangiogram. Circulation, Volume 150, Issue Suppl_1 , Page A4118882-A4118882, November 12, 2024. of all congenital cardiac anomalies.
Coronary angiography revealed a tortuous and extremely aneurysmal RCA, as well as multivessel coronary artery disease (mvCAD) involving LAD, D1, LCx, OM1. Notably, the LAD had multiple aneurysmal segments and areas of eccentric stenosis upto 90%.Multislice
Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Finally, coronary angiography was performed (at least 5 days after presentation) which confirmed LAD aneurysm with large thrombus burden, TIMI 0 flow, thrombectomy performed. No further cath details available.
There are no Q-waves to suggest old inferior MI, or inferior aneurysm as the etiology of the ST Elevation. Case Continued The patient was discharged from the hospital with a plan for a scheduled coronaryangiogram to assess the coronary arteries and the possibility of aortic valve replacement.
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