Wrap-around LAD and the role of multimodal imaging

Q4 Medicine

Radiology Case Reports Pub Date : 2025-04-26 DOI:10.1016/j.radcr.2025.04.018

Maria Jose Santa-Ana-Bayona MD , Camila Ponce-Acosta MD , Gilberto H. Acosta-Gutiérrez MD , Miguel Ángel Pardiño-Vega MD , Mauricio Garcia-Cadernas MD , Enrique Ruiz-Mori MD , Natalia Martinez-Jimenez MD , Enrique C. Guerra MD , Nilda Espinola-Zavaleta MD

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引用次数: 0

Abstract

Acute myocardial infarction remains a major cause of morbidity and mortality, with the left anterior descending artery being most commonly implicated. Anatomical variants, such as the “wrap-around” configuration, can significantly influence myocardial perfusion patterns, infarct size, and clinical outcomes, emphasizing the importance of accurate identification in acute coronary syndromes. We present the case of a 72-year-old male with ST-segment elevation myocardial infarction (STEMI), whose initial electrocardiogram indicated an anteroseptal infarction. Due to limited access to catheterization facilities, thrombolytic therapy was administered, achieving successful reperfusion. A subsequent multimodal imaging assessment revealed an atypical infarct distribution and identified a wrap-around left anterior descending artery with critical stenosis, highlighting the variant’s diagnostic and therapeutic relevance in STEMI management and the utility of multimodal imaging.

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环绕LAD和多模态成像的作用

急性心肌梗死仍然是发病率和死亡率的主要原因，与左前降支最常见的牵连。解剖变异，如“环绕”构型，可以显著影响心肌灌注模式、梗死面积和临床结果，强调了准确识别急性冠状动脉综合征的重要性。我们提出的情况下，一个72岁的男性与st段抬高心肌梗死（STEMI），其初始心电图显示为房间隔梗死。由于获得导管设备的机会有限，因此进行了溶栓治疗，实现了成功的再灌注。随后的多模式成像评估显示非典型梗死分布，并确定了严重狭窄的环绕左前降支，强调了该变体在STEMI管理中的诊断和治疗相关性以及多模式成像的实用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.