Make the Diagnosis: Guess the Vessel

(MedPage Today) -- Case Findings: A 50-year old male with family history significant for premature CAD presents with chest pain which started 3 hours ago. Blood pressure 150/90 mm Hg, HR 60/min. EKG in the emergency department is shown (see image below). Successful intervention of the culprit coronary artery is performed with one drug eluting stent. He is started on aspirin, ticagrelor, atorvastatin and metoprolol. Next morning he is found to be hypotensive to SBP 90s. Hemoglobin, creatinine and electrolytes are normal. Right groin access site is without any hematoma. A stat bedside echocardiogram reveals ejection fraction 55%, no significant valvular dysfunction, mild right ventricular dilation. A diagnosis of right ventricular failure is made and intravenous hydration is initiated. What is the culprit vessel segment?
Source: MedPage Today Cardiovascular - Category: Cardiology Source Type: news