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Video Series Demonstrating Isolated Septal Artery Infarction in a Cocaine User

11/01/2021

Introduction

Video supplement to “Isolated Septal Artery Infarction in a Cocaine User,” by Bawamia, et al. (November 2021 Clinical Images).

A 30-year-old patient who frequently used cocaine presented to the emergency department with a 3-hour history of central chest pain and anterior ST-segment elevation on electrocardiogram. Emergent coronary angiography showed flush occlusion of the septal perforator with retrograde filling from the right coronary artery, which is demonstrated in the following video series. Septal branches arising from the left anterior descending coronary artery supply the anterior interventricular septum in unison. In this unusual presentation of cocaine heart disease, occlusion of a single dominant septal perforator caused a large septal myocardial infarction, resulting in significant left ventricular impairment.

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