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A 72 year old male presented with central chest pain radiating to the left arm. He had similar symptoms 14 weeks previously associated with a positive exercise stress test. A subsequent coronary angiogram revealed a severe stenosis in the proximal aspect of a large right coronary artery. The left coronary system was normal. A bare metal stent was used to treat the stenosis in the right coronary artery following which the patient had been asymptomatic until the current presentation.
His medications included aspirin, clopidogrel, atrovastatin and ramipril.
Investigations were as follows:
serum cardiac troponin T
stopped after 3 minute due to chest tightness and ST segment depression in leads II, III and aVf
What is the cause of the presentation?
intimal dissection at the site of original angioplasty and stent.
subacute thrombosis within stent
subacute stenosis within stent due to neointimal proliferation
new symptomatic atheromatous lesion in a different coronary artery
new symptomatic atheromatous lesion in the right coronary artery
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