An Uncommon Coronary Finding in a Chest Pain Patient

Abstract

A 58-year-old male, an active smoker presented to the hospital with chest discomfort and palpitations following alcohol consumption. His vital signs were stable, though physical examination was unremarkable. Laboratory investigations revealed a markedly elevated Troponin I level of 1852.1 ng/L. His electrocardiogram (ECG) showed a partial right bundle branch block. He was diagnosed with a non-ST elevation myocardial infarction (NSTEMI) and started on dual antiplatelet therapy and subcutaneous Fondaparinux. Coronary angiography (Fig 1) followed by multislice coronary CT angiogram (CCTA) (Fig 2 and 3) was performed to assess the extent of coronary artery disease in the next day.