Spontaneous Vanishing of Coronary Collaterals During Cardiac Catheterization for Acute Myocardial Infarction

Abstract

A patient with acute ST segment elevation inferior myocardial infarction underwent urgent cardiac catheterization. Left coronary arteriography demonstrated minor coronary disease with well-defined collateral filling of the dominant right coronary artery. Shortly thereafter, right coronary arteriography demonstrated entirely normal findings, and a repeat left coronary angiogram no longer demonstrated coronary collaterals. The vanishing coronary collaterals are consistent with acute myocardial infarction from transient occlusion of the right coronary artery. These findings are consistent with the phenomenon of myocardial infarction in the presence of angiographically normal coronary arteries. The transient coronary occlusion in this patient is likely secondary to spontaneous lysis of intracoronary thrombus or transient coronary vasospasm.




J Med Cases. 2016;7(12):527-530
doi: https://doi.org/10.14740/jmc2667w