Hemodynamic Assessment of Stable, Intermediate Lesions in the Catheterization Laboratory Using FFR or iFR
A 70-year-old man with a history of hypertension, hypercholesterolemia, and smoking started complaining about chest pain with mild exertion (Canadian Cardiovascular Society Class III) and thus consulted a cardiologist. A stress electrocardiography test was performed showing symptoms and 1.5 mm ST depression in V4-V5-V6 at the peak of the exercise. Furthermore, a computed tomography (CT) scan was performed showing 3-vessel coronary disease, with a calcium score over 400. Subsequently, the patient underwent coronary angiography that confirmed the results of the CT scan, showing two long, tight lesions in the context of a diffusely diseased left anterior descending (LAD) artery, a 75% lesion at the ostium of a large marginal branch, and a 60% stenosis of the mid right coronary artery (RCA) (Figure 1). The calculated SYNTAX score was 25.
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