Abstract
A borderline left main narrowing was discovered during coronary angiography in a young asymptomatic man with positive stress test. IVUS demonstrated minimal diameter of 2.9 mm and the cross‐sectional area was 11.5 mm2. CTs were performed, and an eccentric calcific plaque was imaged at the ostium of the left main. Based on all three image modalities after discussing the different therapeutic options with the patient he was referred for bypass surgery.