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The following electronic only article is published in conjunction with this issue of Heart.

An unusual cause of abrupt vessel closure

J B Foley, J Cosgrave, D S O’Briain

A 60 year old woman presented with chest pain. An ECG showed ST depression across the anterior leads and lateral T wave inversion and angiography showed a significant proximal circumflex lesion. After percutaneous intervention to the circumflex artery she had a cardiac arrest and died. Postmortem examination found a stent blocked with a combination of thrombus and a tangle of translucent material. Embolic coronary artery occlusion is well described but this is the first report of embolisation of material arising from the lining of the guiding catheter as the cause.

(Heart 2005;91:e19) www.heartjnl.com/cgi/content/full/91/3/e19

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