You are here

Article Text

Article menu
Download PDFPDF
Image challenge
Interpretation of a coronary angiogram
  1. Leah Raj,
  2. David Shavelle,
  3. Anilkumar Mehra
  1. Internal Medicine/Division of Cardiology, University of Southern California, Los Angeles, California, USA
  1. Correspondence to Dr David Shavelle, Division of Cardiovascular Medicine, University of Southern California, Los Angeles, CA 90033, USA; shavelle{at}usc.edu

https://doi.org/10.1136/heartjnl-2018-314213

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Clinical Introduction

    A 42 year-old man with hypertension, hyperlipidaemia and tobacco abuse presented with typical chest pain. The pain was located in the substernal area, described as squeezing, non-radiating and awoke him from sleep. The pain was not associated with shortness of breath, abdominal pain, nausea and diaphoresis. On physical examination, blood pressure was 171/115 mm Hg, heart rate was 60 beats/min, heart sounds were normal without murmur, lung fields were clear and there was no peripheral oedema. Initial ECG showed upsloping ST segments in leads V2–V4. Given the presence of multiple cardiac risk factors, the description of pain and the findings of the ECG, coronary angiography was pursued (Figure 1A–D).

    Figure 1

    (A) Coronary angiogram. Left anterior oblique cranial projection. (B) Right anterior oblique cranial projection. (C) Left anterior …

    View Full Text

    Footnotes

    • Contributors DS: conception and design, drafting of the manuscript, revising the manuscript critically for important intellectual content and final approval of the submitted version. LR: drafting of the manuscript, revising the manuscript critically for important intellectual content and final approval of the submitted version. AM: revising the manuscript critically for important intellectual content and final approval of the submitted version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.