Figure 1.

Coronary catheterization images. A, The patient was admitted in cardiology department for acute thoracic pain in May 2013. Electrocardiogram evidenced inferior Q waves with ST elevation. Echography revealed antero-inferior akinesia. Coronary catheterization showed a thrombosis in the right coronary artery (arrow). B, A month later, the patient presented again with typical acute chest pain despite dual antiplatelet therapy and vitamin K antagonist. Electrocardiogram always evidenced inferior Q waves with no other abnormalities. Echography found the known antero-inferior akinesia. Ultrasensitive troponins were elevated (560 ng/L, n < 14). A new coronary catheterization was performed and evidenced a thrombosis in the right coronary artery and a new asymptomatic incomplete intraluminal obstruction of the circumflex artery (arrow).