title: 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.
abstract: A 56-year-old man had an attack of chest pain associated with ST-segment elevation in both the inferolateral and anteroseptal leads on electrocardiography. Emergency coronary angiography showed thrombus in the mid right coronary artery and total occlusion in the distal left anterior descending coronary artery. Intravenous heparin infusion and antiplatelet therapy were given without other coronary intervention. After 1 week, repeat coronary angiography showed neither significant stenosis nor thrombus in the coronary arteries. Severe coronary artery spasm in the left coronary artery was induced by the provocation test with intracoronary injection of 50 microg acetylcholine. He had an uneventful hospital course. This unique case demonstrated intracoronary thrombus formation in the right coronary artery and left anterior descending coronary artery simultaneously due to suspected coronary spasm.
authors.affiliation: Division of Cardiology, Tokushima Red Cross Hospital, Shinbiraki 28-1, Chuden-cho, Komatsushima, Tokushima 773-0015. suznaoki@tokushima-med.jrc.or.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tomokane
authors.forename: Riyo
authors.initials: R
authors.lastname: Ogura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ohara
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yuba
authors.forename: Takefumi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hosokawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Kishi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohtani
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000473:pathology; D003329:Coronary Vasospasm / Q000150:complications*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*