culprit lesion
The specific coronary artery stenosis responsible for causing an acute coronary syndrome.
Full Definition
A culprit lesion refers to the particular atherosclerotic plaque or coronary stenosis that has undergone acute changes (such as plaque rupture, erosion, or thrombosis) leading to an acute coronary syndrome including unstable angina, NSTEMI, or STEMI. Identification of the culprit lesion is crucial for determining the optimal revascularization strategy, particularly in patients with multivessel disease. Angiographic features that suggest a culprit lesion include thrombus, ulceration, irregular borders, reduced flow, and correlation with ECG changes or regional wall motion abnormalities. In primary PCI, the culprit lesion is typically treated first, with staged intervention considered for non-culprit lesions.
Usage
Usage note: Distinguish from non-culprit lesions, which may also require treatment but are not causing the acute event.
In Context
- "The mid-LAD lesion was identified as the culprit lesion based on ECG changes and angiographic appearance." — Primary PCI report
- "Complete revascularization included treatment of both culprit and non-culprit lesions during the index procedure." — Interventional cardiology note