Lipid-rich plaque masquerading as a coronary thrombus.

A 43-year-old woman presented with exertional chest pressure. Right coronary angiography showed a clear filling defect. Intravascular ultrasound revealed a plaque with 80% stenosis and a large lipid pool. Therefore, a stent was placed, and the patient became angina-free. Lipid-rich plaques are a cause of angiographic filling defects. Intravascular ultrasound is an integral part of coronary artery evaluation.