<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Introduction: combined myocardial infarction (MI) is defined as the simultaneous ischemic injury of two different myocardial territories, raising the possibility of multiple culprit lesions. The anomalous origin of a coronary artery could represent an important challenge during percutaneous coronary intervention (PCI). Case presentation: A 46 year old, smoker Caucasian male presented to a territorial hospital four hours after the onset of severe angina. Consecutive electrocardiograms showed complete atrioventricular block and inferior ST segment elevation (STE), later PQ prolongation with right bundle branch block plus STE in leads V4-V6. After administration of thrombolytic treatment, the patient was transferred to the regional PCI center. Emergent coronary angiography revealed acute occlusion of the left anterior descending artery (LAD) and a thrombus containing, severe stenosis of the anomalously originated right coronary artery (RCA). Rescue PCI with stent implantation in the LAD and RCA was performed nine hours after pain onset. At the 1 year follow-up visit the patient had no angina or heart failure symptoms. Conclusion: this is the first report of a combined MI caused by acute, sequentially occurring thrombotic occlusion of two coronary arteries, one of them with anomalous origin, in a patient treated by rescue PCI following partially successful thrombolysis.</p></abstract>

Introduction: combined myocardial infarction (MI) is defined as the simultaneous ischemic injury of two different myocardial territories, raising the possibility of multiple culprit lesions. The anomalous origin of a coronary artery could represent an important challenge during percutaneous coronary intervention (PCI). Case presentation: A 46 year old, smoker Caucasian male presented to a territorial hospital four hours after the onset of severe angina. Consecutive electrocardiograms showed complete atrioventricular block and inferior ST segment elevation (STE), later PQ prolongation with right bundle branch block plus STE in leads V4-V6. After administration of thrombolytic treatment, the patient was transferred to the regional PCI center. Emergent coronary angiography revealed acute occlusion of the left anterior descending artery (LAD) and a thrombus containing, severe stenosis of the anomalously originated right coronary artery (RCA). Rescue PCI with stent implantation in the LAD and RCA was performed nine hours after pain onset. At the 1 year follow-up visit the patient had no angina or heart failure symptoms. Conclusion: this is the first report of a combined MI caused by acute, sequentially occurring thrombotic occlusion of two coronary arteries, one of them with anomalous origin, in a patient treated by rescue PCI following partially successful thrombolysis.

Combined Myocardial Infarction in a Young Patient with Anomalous Coronary Artery Anatomy: A Case Report

Univeristy of Medicine and Pharmacy of Tîrgu Mureș, Romania

Emergency Institute for Cardiovascular Diseases and Transplantation of Tîrgu Mureș, Romania

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Introduction: combined myocardial infarction (MI) is defined as the simultaneous ischemic injury of two different myocardial territories, raising the...

Combined Myocardial Infarction in a Young Patient with Anomalous Coronary Artery Anatomy: A Case Report

Published Online: Feb 09, 2016

Page range: 135 - 137

Received: Aug 18, 2015

Accepted: Sep 11, 2015

DOI: https://doi.org/10.1515/amma-2015-0102

Keywords
combined myocardial infarction, coronary artery anomaly, thrombolysis, rescue percutaneous coronary artery intervention

© by László Hadadi

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Combined Myocardial Infarction in a Young Patient with Anomalous Coronary Artery Anatomy: A Case Report

Published Online: Feb 09, 2016

Page range: 135 - 137

Received: Aug 18, 2015

Accepted: Sep 11, 2015

DOI: https://doi.org/10.1515/amma-2015-0102

Keywordscombined myocardial infarction, coronary artery anomaly, thrombolysis, rescue percutaneous coronary artery intervention

© by László Hadadi

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
combined myocardial infarction, coronary artery anomaly, thrombolysis, rescue percutaneous coronary artery intervention