Multivessel Coronary Artery Thrombosis

Yumiko Kanei, MD; Rajesh Janardhanan, MD; John T. Fox, MD; Ramesh M. Gowda, MD

Disclosures

J Invasive Cardiol. 2009;21(3):66-68. 

In This Article

Abstract and Introduction

Abstract

Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in ST-segment elevation myocardial infarction (STEMI). We describe a 37-year-old male present with inferior wall STEMI who was found to have large thrombi in both the right coronary artery (RCA) and the left anterior descending artery (LAD). We reviewed 23 patients with multivessel thrombosis in acute myocardial infarction in the literature. The mean age of patients was 53 ± 14 years (32-82 years); 74% were males, and most patients had multiple risk factors for coronary artery disease. The LAD (78%) and RCA (87%) were the arteries involved for most patients. Aspiration thrombectomy was used in 3 cases. Though it is rare, STEMI with multiple culprit arteries can occur, and it is crucial to recognize this condition to determine the proper treatment, since most of these patients are critically ill.

Introduction

Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in ST-segment elevation myocardial infarction (STEMI). Most patients with acute multivessel thrombosis are critically ill, and the recognition of this condition is of paramount importance to enable prompt and appropriate management. We present a case and review all previously reported cases of multiple coronary thromboses.

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