Whole-heart coronary magnetic resonance angiography in a patient with unstable angina

Abstract

A 67-year-old man was transferred to the emergency department because of anterior chest pain which persisted for 30 min. He had no significant coronary risk factors. Upon admission, there were no ST segment elevations or T wave abnormalities. Initial serum creatine kinase was 116 IU/l and troponin I was negative. Echocardiography revealed no left ventricular regional wall motion abnormality. The patient was referred to whole-heart coronary magnetic resonance angiography (MRA) with a provisional diagnosis of unstable angina. MRA was performed using a free-breathing, 3dimensional navigator technique [1]. Volume rendering image showed stenosis in the proximal portion of the left anterior descending artery (Fig. 1A, arrow). Maximum intensity projection image demonstrated high-grade stenosis in the left anterior descending artery immediately distal to the bifurcation point (Fig. 1B, arrow). Conventional coronary angiography revealed subtotal occlusion of the left anterior descending artery (Fig. 2, arrow).