Coronary Angiogram of a young man with MI

Coronary Angiogram of a 25 years old male who was thrombolysed for Anterior Wall Myocardial Infarction and coronary angiography was done later.

This is an AP Cranial view, the Left Coronary Artery is engaged and dye is being injected into it. The vessel most prominent is the LAD.

LAD highlighted

If you look closely in the above video, you can find 2 things. First there are small filling defects in the proximal part of the LAD artery, these are clots that have not completely lysed by thrombloysis. The flow however is good in the distal vessel and these are not occluding the vessel at present. The place where you need to look for clots has been circled with red in the image below.

The area circled in blue is where you will notice a Myocardial Bridge. The vessel seems to be constricting and relaxing with each cardiac cycle. Here, the vessel actually passes underneath a small 'bridge' of myocardium and when the myocardium contracts it compresses the vessel as well. You might want to view clip a few times appreciate these findings!