[Two cases of acute myocardial infarction with simultaneous occlusions of two main coronary branches].
We report two rare cases of acute myocardial infarction with simultaneous occlusion of two main coronary branches. Case 1 was a 66-year-old man. Emergent CAG demonstrated total occlusions of RCA-segment 1 and LCX-segment 13. The patient underwent a direct PTCA of the RCA occlusion and an intracoronary infusion of urokinase. Angiography before discharge revealed a 25% stenosis of the RCA and a 75% stenosis of the LCX. Case 2 was a 68-year-old man. His ECG showed ST elevation in inferior and anterior leads. Emergent CAG demonstrated a 99% stenosis of RCA-segment 1 and total obstruction in LAD-segment 6. The distal LAD was not visualized by antegrade and retrograde flow from collaterals. We considered the state of hyper-coagulability and reducing of coronary blood flow as the mechanism of simultaneous occlusions in our cases.
Division of Cardiology, Komatsushima Red Cross Hospital.
K
K
Kishi
Y
Y
Hiasa
N
N
Kondo
H
H
Fujinaga
Y
Y
Ohishi
R
R
Ohtani
T
T
Wada
T
T
Aihara
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D014568:Urokinase-Type Plasminogen Activator