Late progression of an asymptomatic intimal tear to occlusive coronary artery dissection following angioplasty.

Symptomatic coronary artery dissection is a recognized complication of coronary angioplasty that is usually associated with immediate adverse consequences. In contrast, the asymptomatic angiographic finding of an "intimal tear" following otherwise successful angioplasty has been considered clinically unimportant. A case is reported of a primarily successful coronary angioplasty with intimal tear that progressed to occlusive coronary artery dissection requiring coronary bypass surgery at 4 weeks postangioplasty. This case demonstrates that an asymptomatic intimal tear following successful coronary angioplasty is not always an innocuous angiographic finding.