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Int J Angiol 2005; 14(1): 34-36
DOI: 10.1007/s00547-005-1096-0
Case Reports

© Georg Thieme Verlag KG Stuttgart · New York

Coronary angioscopy revealing ruptured plaque and thrombus causing acute anterior myocardial infarction with a subsequent acute inferior myocardial infarction — a case report

Yuji Okuyama, Masaya Usami, Yasunori Ueda, Tomohito Ohtani, Yasuharu Takeda, Isamu Mizote, Atsushi Hirayama, Kazuhisa Kodama
  • Cardiovascular Division, Osaka Police Hospital, Tennoji-ku, Osaka, Japan
Yuji Okuyama and Masaya Usami, contributed equally to this report
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Publication History

Publication Date:
27 April 2011 (online)

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Abstract

We report a unique case that suggests that a thrombotic coronary occlusion was caused by local plaque rupture in the left anterior descending coronary artery (LAD), with subsequent thrombotic occlusion in the right coronary artery (RCA), and presented with simultaneous double coronary artery occlusions. ST-segment elevations in the precordial leads and cardiac tamponade were observed first, followed by ST-segment elevations in the inferior leads. Emergency coronary intervention for the RCA lesion resulted in further ST-segment elevation, suggesting an acute inferior infarction. A left ventricular rupture was found in the anterolateral wall, consistent with acute anterior infarction. Angioscopy one month later revealed the presence of ruptured plaque with thrombus, in both the LAD and the RCA.

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