Emergency coronary stenting for complete thrombotic occlusion of an unprotected left main coronary artery in acute myocardial infarction complicated by cardiogenic shock in an octogenarian patient--a case report.
This report concerns an 82-year-old white man, who was admitted with cardiogenic shock secondary to an acute anterior myocardial infarction with right bundle branch block requiring an intra-aortic balloon pump for hemodynamic support and mechanical ventilatory support for respiratory distress. An immediate cardiac catheterization with coronary angiography revealed a complete thrombotic occlusion of the left main coronary artery. Prompt stent-supported percutaneous transluminal coronary angioplasty to the occluded left main coronary artery, a critical stenosis of the ostial left anterior descending artery, and the left circumflex coronary artery, allowed for recovery from this life-threatening condition and subsequent discharge from the hospital of this octogenarian patient. It is suggested that in a critical clinical condition with particularly challenging coronary anatomical findings, stent-supported coronary angioplasty can be lifesaving treatment in selected patients with octogenarian status with acute myocardial infarction.
Tariq
M
M
Department of Medicine, Conemaugh Memorial Medical Center, Johnstown, PA 15905, USA.
Carroll
R
R
Zabih
I
I
Stenberg
R G
RG
Hussain
K M A
KM
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D002037:Bundle-Branch Block / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D003328:Coronary Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D004638:Emergency Treatment; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D015607:Stents