To view the full text, please login as a subscribed user or purchase a subscription. Click here to view the full text on ScienceDirect. A 29-year-old male with no risk factors presented with anterior ST elevation. RRA access coronary angiography revealed an occluded left anterior descending (LAD). Glycoprotein IIb/IIIa inhibition was withheld due to initial distal LAD wire dissection.