Left Circumflexus Coronary Artery Total Occlusion with Clinical Presentation as NSTEMI and Acute Pulmonary Oedema
Abstract: Current guidelines
for the management of patients with acute coronary syndromes (ACSs) focus on
the electrocardiogram to divide patients into ST-elevation acute myocardial
infarction (STEMI) or non-ST-elevation acute myocardial infarction
(NSTEMI)/unstable angina (UA). Patients with STEMI in the earliest time will
receive reperfusion therapy to destruct occlusive thrombus. An ST segment
elevation is the ‘sine qua non’ for diagnosing acute total coronary occlusion
causing transmural myocardial infarction. Left circumflex coronary artery (LCx)
occlusion is often categorized as NSTEMI because of the absence of significant
ST-elevation on the 12 lead standard electrocardiogram. An ST segment elevation
is presented in fewer than 50% of patients with LCx total occlusion, such that
the reperfusion therapy is delayed. We reported a 77 years old woman whom being
diagnosed with NSTEMI because a 12 lead electrocardiogram showed ST segment
depression in lead V2-V5. On coronary angiography, we found a total occlusion
in the LCx artery as the culprit lession.
Keywords: ST-elevation acute
myocardial infarction (STEMI); culprit lession; total occlusion; Left
Circumflex
Author: Budi Yuli Setianto,
Nahar Taufiq, Heri Hernawan
Journal Code: jpkedokterangg170342
