Clinical introduction A 42-year-old woman presented with anterior ST elevation myocardial infarction. Urgent coronary angiography revealed tapering then occlusion of the distal left anterior descending (LAD) coronary artery with no flow in the distal LAD (figure 1A). Balloon angioplasty with a 2.0×8 mm balloon re-established flow into the distal LAD. An angiogram of the right external iliac artery was also performed (figure 1B).
Question Which of the following explains the abnormal appearance of the external iliac artery (figure 1B)?
- acute coronary syndromes
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Contributors AJW and ARI performed the clinical case, recognised the association of spontaneous coronary dissection with fibromuscular dysplasia of non-coronary artery and gathered the images. JKF, ARI and AJW drafted the manuscript and gave final approval of the version published. JKF, ARI and AJW agreed to be accountable for all aspects of the work.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.