Multivessel acute coronary thrombosis and occlusion--an unusual cause of cardiogenic shock.
A 44-year-old male was admitted with ST-elevation myocardial infarction and cardiogenic shock. Angiography revealed a left anterior descending artery (LAD) as well as right a coronary artery acute thrombotic occlusion and large mobile thrombi in the circumflex artery. He was treated mainly with multivessel thrombus aspiration and intra-aortic balloon insertion. Subsequent intravascular ultrasound a week later revealed mild disease of the LAD only. We suggest that in selected patients with cardiogenic shock, plaque rupture with resultant acute thrombosis in a single coronary artery may lead to low coronary perfusion pressure and consequent multivessel thrombus formation. Thrombus aspiration should be the main therapeutic modality in such unusual cases.
Turgeman
Yoav
Y
Department of Cardiology, Ha'Emek Medical Center, Afula, Israel.
Suleiman
Khaled
K
Atar
Shaul
S
D000328:Adult; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications* / Q000000981:diagnostic imaging; D003328:Coronary Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D003331:Coronary Vessels; D004562:Electrocardiography; D006801:Humans; D008297:Male; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000209:etiology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology; D018084:Ultrasonography, Interventional