title: [Two cases of acute myocardial infarction with simultaneous occlusions of two main branches].
abstract: Acute myocardial infarction with simultaneous occlusions of two main branches is very rare, and it is difficult to presume it before performing emergent CAG. We encountered two such cases recently. Case 1 was a 77 year-old woman. She was admitted to our hospital because of anterior chest pain. Emergent CAG disclosed complete occlusions of RCA-Segment 3 and LAD-Segment 7. ICT improved both of them to 90% stenoses. Case 2 was a 58 year-old man. He was admitted to our hospital because of upper abdominal pain. Emergent CAG disclosed complete occlusions of RCA-Segment 2 and LAD-Segment 6. ICT improved the former to 99% stenosis, and the latter recanalized. Myocardial dual scintigrams performed during the acute periods showed findings which were consistent with simultaneous occlusion of the two main branches in both cases. We could consider such reasons as coronary vasospasm, state of hyper-coagulability at the onset of myocardial infarction and depression of coronary pressure etc as possible causes of these cases.
authors.affiliation: Department of Cardiology, Ogaki Municipal Hospital.
authors.forename: H
authors.initials: H
authors.lastname: Toyoda
authors.forename: K
authors.initials: K
authors.lastname: Sawada
authors.forename: J
authors.initials: J
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Tsuboi
authors.forename: T
authors.initials: T
authors.lastname: Sone
authors.forename: H
authors.initials: H
authors.lastname: Sassa
mesh_terms: D000368:Aged; D001777:Blood Coagulation; D001794:Blood Pressure; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology*; D003329:Coronary Vasospasm / Q000150:complications; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D011877:Radionuclide Imaging