Coronary Artery Disease USMLE Step 1 Practice Question
A 45-year-old man with familial hypercholesterolemia (LDL 280 mg/dL despite statin therapy) presents with acute ST-elevation myocardial infarction. He is taken urgently for PCI. During the procedure, the interventionalist notes that the coronary artery has a diffuse, homogeneous, grayish appearance with significant calcification throughout. Which of the following best describes this angiographic finding and its clinical implication?
Answer choices
- AThrombus requiring thrombectomy and no additional intervention
- BCoronary artery dissection requiring immediate CABG consultation
- CAtherosclerotic plaque with calcification requiring rotational atherectomyCorrect answer
- DEmbolic protection device deployment before stent placement
- ESpontaneous coronary artery dissection with vessel wall disruption
- FCoronary artery spasm requiring immediate intracoronary nitroglycerin and calcium channel blocker administration
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