“Lotus root”: a novel optical coherence tomography imaging pattern in spontaneous coronary artery dissection

A 48-year-old woman with previous history of hyperthyroidism caused by Graves' disease presented with unstable angina. Three years before, the patient was admitted for a non-ST-segment elevation myocardial infarction. At that time, coronary angiography revealed severe coronary artery tortuosity with an abrupt and diffuse lumen narrowing of the distal left anterior descending coronary artery (LAD) as a result of spontaneous coronary artery dissection (SCAD) presenting as an intramural haematoma (Figure 1A, Moving image 1) with no stenosis in the right coronary artery (RCA) (Figure 1B, Moving image 2). The patient was successfully managed conservatively, and further angiography screening identified stigmas of fibromuscular ...