culprit lesion
The specific coronary stenosis responsible for the patient's acute coronary syndrome or presenting symptoms.
Full Definition
A culprit lesion is the specific atherosclerotic stenosis identified as the primary cause of the patient's acute coronary syndrome, myocardial infarction, or presenting anginal symptoms. Identification of the culprit lesion is crucial for treatment prioritization, especially in patients with multivessel coronary disease. The culprit lesion is typically characterized by features such as complex morphology, thrombus presence, ulceration, or correlation with electrocardiographic changes and regional wall motion abnormalities. In acute settings, the culprit lesion usually receives primary intervention, while non-culprit lesions may be addressed in staged procedures. Accurate identification requires integration of clinical presentation, imaging findings, and sometimes physiologic assessment.
Usage
Usage note: Clearly distinguish from non-culprit lesions in multivessel disease.
In Context
- "The culprit lesion in the mid-LAD showed complex morphology with visible thrombus." — STEMI procedure report
- "Primary PCI was performed on the culprit lesion, with staged intervention planned for non-culprit disease." — Treatment planning documentation