The evolution of acute coronary syndromes (ACS) is not always clearly understood, and our understanding has been limited by the absence of serial information regarding the coronary vasculature in these patients. We describe a young patient with an acute inferior wall myocardial infarction in whom repeat multi-detector computed tomographic scanning (MDCT), supported by invasive studies, revealed a transient filling defect in the proximal left anterior descending coronary artery and nonobstructed circumflex and right coronary arteries. New generation 64-slice MDCT scanning provides a new method for visualizing both the coronary lumen and coronary plaque, and may prove to be a useful tool in improving our understanding of the dynamics of ACS.
2006 Wiley-Liss, Inc.