title: Double vessel acute myocardial infarction showing simultaneous total occlusion of left anterior descending artery and right coronary artery.
abstract: Simultaneous double vessel acute myocardial infarction (AMI) is extremely rare and usually has poor clinical outcomes. Management of this complicated condition is challenging and time-limited. The case of a 46-year-old Taiwanese man with simultaneous anterior and inferior wall AMI is reported. Rapid deterioration of clinical condition with ventricular fibrillations (VF), cardiogenic shock and asystole developed before catheterization. Coronary angiogram revealed simultaneous total occlusion of left anterior descending (LAD) and right coronary arteries (RCA). Frequent VF attack was still noted after diagnostic catheterization. After cardiopulmonary resuscitation, immediate percutaneous coronary intervention of the LAD and RCA, and intra-aortic balloon counterpulsation was inserted. Due to intractable heart failure and cardiogenic shock, extracorporeal membrane oxygenation was performed. Rabdomyolysis with acute renal failure was also noted with hemodialysis treatment. Thirty-one days after hospitalization, he was discharged with a New York Heart Association functional class III heart failure, without hemodialysis.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Institute of Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Sung-Kien
authors.initials: SK
authors.lastname: Sia
authors.forename: Chien-Ning
authors.initials: CN
authors.lastname: Huang
authors.forename: Kwo-Chang
authors.initials: KC
authors.lastname: Ueng
authors.forename: Yi-Liang
authors.initials: YL
authors.lastname: Wu
authors.forename: Kuei-Chuan
authors.initials: KC
authors.lastname: Chan
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003331:Coronary Vessels; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D012720:Severity of Illness Index