Simultaneous occlusion of 2 coronary arteries--a rare cause of cardiogenic shock

The American Journal of Emergency Medicine
Aleksander AraszkiewiczStefan Grajek

Abstract

Unstable coronary artery plaque rupture resulting in acute thrombosis is the most common reason of acute myocardial infarction. Atherosclerotic plaque rupture is thought to reflect local plaque instability attributable to spontaneous or triggered disruption of a vulnerable plaque that is manifested angiographically as a single lesion (culprit lesion). Plaque instability might be caused, however, by pathophysiologic processes, such as inflammation ("panarteritis"), that exert adverse effects throughout the coronary vasculature and therefore result in multiple unstable lesions and multivessel thromboses. We report a case of a 51-year-old man, heavy smoker, who presented with 3-hour history of severe chest pain and signs of cardiogenic shock. A 12-lead electrocardiogram showed third-degree atrioventricular block with junctional rhythm of 35 beats per minute and ST elevations in leads II, III, aVF, and V1 through V6. Temporary endocavital pacing was immediately introduced and initiated. In coronary angiography, simultaneous occlusions of left anterior descending and right coronary arteries were found. Primary angioplasty of both culprit vessels was successfully performed. Intra-aortic balloon pumping was inserted. After interventio...Continue Reading

Citations

Mar 6, 2012·The American Journal of Emergency Medicine·Hesham R OmarEnrico M Camporesi
Jul 22, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Juan CincaDabit Arzamendi
Mar 17, 2015·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Ahmed MahmoudIslam Y Elgendy
Mar 19, 2020·Clinical Case Reports·Irina NordkinMajdi Halabi

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