Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Simultaneous Total Occlusion of Multiple Distal Coronary Arteries in Acute Myocardial Infarction

  • Song, Won-Jun (Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center) ;
  • Koo, Ja-Kyung (Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center) ;
  • Park, Kyoung-Ha (Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center) ;
  • Kim, Min-Kyu (Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center) ;
  • Choi, Young-Jin (Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center)
  • Published : 2011.10.30
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Abstract

Simultaneous multiple coronary artery thrombosis is a rare finding in ST segment elevation myocardial infarction (STEMI). We report a case of myocardial infarction with multiple ST segment elevation on the electrocardiography and total occlusions of the distal left anterior descending artery (dLAD), as well as of the second and third obtuse marginal artery on emergency coronary angiography. Thrombus aspiration was performed at dLAD and systemic glycoprotein IIb/IIIa inhibitor was used successfully. In patients with STEMI, multiple coronary thromboses are unusual and associated with patient fatality. However, assertive thrombus aspiration and antiplatelet therapy could be effective in STEMI patients with multiple distal coronary artery occlusions.

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References

  1. Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O'Neill WW. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med 2000;343:915-22. https://doi.org/10.1056/NEJM200009283431303
  2. Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O'Neill WW. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med 2000;343:915-22. https://doi.org/10.1056/NEJM200009283431303
  3. Kanei Y, Janardhanan R, Fox JT, Gowda RM. Multivessel coronary artery thrombosis. J Invasive Cardiol 2009;21:66-8.
  4. Asakura M, Ueda Y, Yamaguchi O, et al. Extensive development of vulnerable plaques as a pan-coronary process in patients with myocardial infarction: an angioscopic study. J Am Coll Cardiol 2001;37:1284-8. https://doi.org/10.1016/S0735-1097(01)01135-4
  5. Derian W, Hertsberg A. Acute myocardial infarction from simultaneous total occlusion of the left circumflex and right coronary artery. A case report. Int J Cardiol 2007;119:e65-7. https://doi.org/10.1016/j.ijcard.2007.02.056
  6. Svilaas T, Vlaar PJ, van der Horst IC, et al. Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med 2008;358:557-67. https://doi.org/10.1056/NEJMoa0706416
  7. Kang WC, Ahn TH, Han SH, et al. Efficacy of thrombosuction using the export aspiration catheter before primary percutaneous coronary intervention in acute myocardial infarction. Korean Circ J 2005;35:172-9. https://doi.org/10.4070/kcj.2005.35.2.172

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  1. Summation and Cancellation Effects on QRS and ST-Segment Changes Induced by Simultaneous Regional Myocardial Ischemia vol.9, pp.None, 2011, https://doi.org/10.3389/fphys.2018.00275