This is the description of a 40-year-old hypertensive female patient who was also a smoker. The patient was admitted with non-ST elevation myocardial infarction. Baseline coronary angiography revealed a moderate lesion in the mid third of the circumflex artery. Percutaneous treatment of the lesion was indicated. At angiography no lesion on the circumflex artery could be visible, but instead, an extensive dissection in the left descending coronary artery from the ostium to mid third with TIMI III distal flow. Clinical treatment was the choice. However, while in hospital patient's ECG presented recurrent angina and ST elevation. A new coronary angiography revealed dissection extension to the distal part of the vessel, and slower flow (TIMI II). The patient was then successfully submitted to an intra-coronary ultrasound-guided coronary angioplasty with implant of three stents.
Angioplasty, transluminal, percutaneous coronary; Stents; Coronary disease; Aneurysm, dissecting
