OCT in acute MI

Intracoronary OCT (A-C) and coronary angiogram (D) of the right coronary artery in a patient presenting with acute coronary syndrome with sudden onset of chest pain and transient ST elevations in the inferior ECG leads. The coronary angiogram shows a mild, non flow limiting lesion in the right coronary artery (D). Intracoronary OCT reveals atherosclerosis with concentric, mild intimal thickening (A) and focal thrombosis (B, C). A mural thrombus is protruding into the lumen in 3 o'clock position (asterisk) and is casting a shadow on the arterial wall. Thus OCT is able to reveal the pathophysiologic culprit of the patients clinical symptoms, that is missed by angiography.