culprit lesion
The specific coronary artery stenosis or occlusion responsible for the acute coronary syndrome.
Full Definition
A culprit lesion is the specific atherosclerotic plaque or coronary stenosis that has ruptured or eroded to cause the acute coronary syndrome presentation. Identification of the culprit lesion is crucial for determining the target vessel for primary percutaneous coronary intervention. The culprit lesion may not necessarily be the most severe stenosis visible on angiography, as acute events often result from rupture of moderately stenotic but vulnerable plaques. Angiographic characteristics and correlation with ECG changes help identify the culprit vessel.
Usage
Usage note: Distinguish from non-culprit lesions that may be present but not causing the acute event.
In Context
- "Angiography revealed a 90% culprit lesion in the mid-LAD with visible thrombus." — Cardiac catheterization report
- "The culprit lesion showed characteristics of plaque rupture with irregular borders." — Interventional cardiology note