The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Consecutive Multivessel Myocardial Infarction during Primary Percutaneous Coronary Intervention

전벽 심근 경색의 일차 관상동맥 시술 중 연속된 하벽 심근 경색

  • Park, Byoung-Won (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Seo, Dae-Chul (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Ham, Nam-Seok (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Park, Jung-Wan (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Chung, Jin-Wook (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Bang, Duk-Won (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine) ;
  • Hyon, Min-Su (Division of Cardiology, Department of Internal Medicine, Soonchunhyang University College of Medicine)
  • 박병원 (순천향대학교 의과대학 내과학교실 심장내과) ;
  • 서대철 (순천향대학교 의과대학 내과학교실 심장내과) ;
  • 함남석 (순천향대학교 의과대학 내과학교실 심장내과) ;
  • 박정완 (순천향대학교 의과대학 내과학교실 심장내과) ;
  • 정진욱 (순천향대학교 의과대학 내과학교실 심장내과) ;
  • 방덕원 (순천향대학교 의과대학 내과학교실 심장내과) ;
  • 현민수 (순천향대학교 의과대학 내과학교실 심장내과)
  • Received : 2013.08.23
  • Accepted : 2013.09.24
  • Published : 2014.09.01
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Abstract

ST-elevation myocardial infarction (STEMI) involving multivessel coronary arteries is extremely rare. Consecutive STEMI in a nonculprit vessel during primary percutaneous coronary intervention (PCI) of the culprit vessel has not been reported. A 53-year-old male presented to the emergency department with anterior wall STEMI. Just after successful primary PCI of the left anterior descending artery, inferior wall STEMI developed. PCI of the right coronary arteries was performed successfully. Five days later, the patient was discharged without symptoms of heart failure. This case underlines the high thrombogenicity along the coronary arteries in patients with STEMI.

가슴 통증을 호소한 환자가 전벽 ST분절 상승 심근경색으로 좌전하행지의 일차 관상동맥 재개통술 시행하였고 직후 하벽 ST분절 상승 심근경색이 연속적으로 발생하여 우관상동맥 재개통술을 성공적으로 시행한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 이는 ST분절 상승 심근경색 환자에서 비원인 관상동맥 병변을 치료하는 것도 세심한 주의가 필요함을 말해주고 있다.

Keywords

References

  1. Gan F, Hu D, Dai T. Acute multivessel coronary artery occlusion: a case report. BMC Res Notes 2012;5:523. https://doi.org/10.1186/1756-0500-5-523
  2. Sia SK, Huang CN, Ueng KC, Wu YL, Chan KC. Double vessel acute myocardial infarction showing simultaneous total occlusion of left anterior descending artery and right coronary artery. Circ J 2008;72:1034-1036. https://doi.org/10.1253/circj.72.1034
  3. Suzuki N, Hiasa Y, Miyazaki S, et al. Acute myocardial infarction caused by simultaneous occlusion of the right coronary artery and the left anterior descending coronary artery probably due to coronary spasm: a case report. J Cardiol 2005;45:213-217.
  4. Muller DW, Topol EJ, Ellis SG, Sigmon KN, Lee K, Califf RM. Multivessel coronary artery disease: a key predictor of short-term prognosis after reperfusion therapy for acute myocardial infarction: thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group. Am Heart J 1991;121(4 Pt 1):1042-1049. https://doi.org/10.1016/0002-8703(91)90661-Z
  5. Lee HW, Hong TJ, Yang MJ, et al. Comparison of infarct-related artery vs. multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: analysis from Korea Acute Myocardial Infarction Registry. Cardiol J 2012;19:256-266. https://doi.org/10.5603/CJ.2012.0047
  6. Toutouzas K, Synetos A, Karanasos A, Tsiamis E, Stefanadis C. Simultaneous occlusion of two coronary arteries in a patient with acute myocardial infarction: a result of plaque rupture and plaque erosion. Int J Cardiol 2011;152:e29-30. https://doi.org/10.1016/j.ijcard.2010.09.071
  7. Arbustini E, Dal Bello B, Morbini, et al. Plaque erosion is a major substrate for coronary thrombosis in acute myocardial infarction. Heart 1999;82:269-272. https://doi.org/10.1136/hrt.82.3.269
  8. Davies MJ, Thomas A. Thrombosis and acute coronary-artery lesions in sudden cardiac ischemic death. N Engl J Med 1984;310:1137-1140. https://doi.org/10.1056/NEJM198405033101801
  9. O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;127:e362-425. https://doi.org/10.1161/CIR.0b013e3182742cf6
  10. Steg PG, James SK, Atar D, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569-2619. https://doi.org/10.1093/eurheartj/ehs215
  11. Ten Berg JM, van 't Hof AW, Dill T, et al. Effect of early, pre-hospital initiation of high bolus dose tirofiban in patients with ST-segment elevation myocardial infarction on short- and long-term clinical outcome. J Am Coll Cardiol 2010;55:2446-2455. https://doi.org/10.1016/j.jacc.2009.11.091
  12. Stone GW, Maehara A, Witzenbichler B, et al. Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction: the INFUSE-AMI randomized trial. JAMA 2012;307:1817-1826. https://doi.org/10.1001/jama.2012.421
  13. Wald DS, Morris JK, Wald NJ, et al. Randomized trial of preventive angioplasty in myocardial infarction. N Engl J Med 2013;369:1115-1123. https://doi.org/10.1056/NEJMoa1305520