JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract A 23 year old man presented with anterior ST elevation myocardial infarction while playing football and gave a 3 week history of recreational intravenous steroid abuse. Coronary angiogram showed a large persistent filling defect in left main stem extending into LAD and intermediate arteries. This was felt to be either spontaneous left main dissection precipitated by heavy exertion or left main stem thrombosis facilitated by intravenous steroid abuse over the previous 3 weeks. He was offered immediate surgical revascularisation but elected instead to have delayed surgery after 2 weeks unless symptoms worsened. Repeat coronary angiogram, two weeks later, however, showed considerable improvement with only a small amount of residual thrombus in left anterior descending artery and hence it was elected to continue with medical treatment. Following further 6 weeks, repeat coronary a...
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