title: Acute myocardial infarction with simultaneous involvement of right coronary artery and left anterior descending artery: a case report.
abstract: Acute myocardial infarction is usually caused by rupture of unstable plaque and involves a single coronary artery. Simultaneous occlusions of multiple coronary arteries in patients with ST elevation myocardial infarction are uncommon and lead to a fatal outcome. We report a 75-year-old male presenting with persistent chest pain complicated by ventricular fibrillation. After defibrillation and cardiopulmonary resuscitation, an emergency coronary angiogram showed total occlusion of the right coronary artery, and thrombus in the proximal left anterior descending artery. Both coronary arteries underwent successful balloon inflation and stenting. The patient finally survived under ventilatory support. This rare case suggests that aggressive reperfusion therapy and even mechanical support to improve poor clinical outcome are suggested in high risk patients with multivessel occlusions.
authors.affiliation: Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Wen-Hsien
authors.initials: WH
authors.lastname: Lee
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003331:Coronary Vessels / Q000601:surgery; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*