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

DOI: 10.4244/EIJ-D-22-00775

David del Val
David del Val1,2, MD, PhD; Teresa Bastante1,2, MD; Fernando Rivero1,2, MD, PhD; Javier Cuesta1,2, MD, PhD; Maria Martinez-Avial1, MD; Fernando Alfonso1,2, MD, PhD
1. Cardiology Department, Hospital Universitario de La Princesa, Madrid, Spain; 2. Instituto de Investigación Sanitaria, IIS-IP, Hospital Universitario de La Princesa, Madrid, Spain
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 ...

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