Infarct related artery

Associate Editor-In-Chief:

Infarct related artery or culprit artery refers to a coronary artery that is blocked or stenosed by atheroma and thrombosis, and responsible for an acute coronary syndrome. Although, there is one culprit artery in majority of cases, there may infrequently (approximately 1% in angioscopy studies) be multiple culprit arteries present in acute coronary syndromes.

Diagnosis of the Infarct Related Artery
Three diagnostic tools are useful in the identification of the culprit artery:
 * Coronary angiography: The presence of an intracoronary filling defect to suggest coronary thrombosis or the presence of a coronary ulcer aids in the identification of the culprit artery. The presence of slow flow in the artery may suggests that it is the culprit artery. However, in the presence of both STEMI and NSTEMI, flow in the non-culprit artery may be slowed as well.
 * The 12 lead EKG or 80 lead EKG may aid in identification of the culprit artery.
 * Left ventriculography may demonstrate a wall motion abnormality which may also assist in the identification of the culprit artery.