Kaohsiung Journal of Medical Sciences
Volume 26, Issue 7 , Pages 384-388, July 2010

Acute Myocardial Infarction With Simultaneous Involvement of Right Coronary Artery and Left Anterior Descending Artery: A Case Report

  • Wen-Hsien Lee

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Po-Chao Hsu

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Tsung-Hsien Lin

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Ho-Ming Su

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Wen-Ter Lai

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Sheng-Hsiung Sheu

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Sheng-Hsiung Sheu, Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 80708, Taiwan

Received 17 November 2009; accepted 11 January 2010.

Article Outline

Acute myocardial infarction is usually caused by rupture of unstable plaque and involves a single coronary artery. Simultaneous occlusions of multiple coronary arteries in patients with ST elevation myocardial infarction are uncommon and lead to a fatal outcome. We report a 75-year-old male presenting with persistent chest pain complicated by ventricular fibrillation. After defibrillation and cardiopulmonary resuscitation, an emergency coronary angiogram showed total occlusion of the right coronary artery, and thrombus in the proximal left anterior descending artery. Both coronary arteries underwent successful balloon inflation and stenting. The patient finally survived under ventilatory support. This rare case suggests that aggressive reperfusion therapy and even mechanical support to improve poor clinical outcome are suggested in high risk patients with multivessel occlusions.

Key Words:  acute myocardial infarction , coronary occlusion , percutaneous coronary intervention

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PII: S1607-551X(10)70063-2

doi:10.1016/S1607-551X(10)70063-2

Kaohsiung Journal of Medical Sciences
Volume 26, Issue 7 , Pages 384-388, July 2010

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