Korean Circ J.  2013 Oct;43(10):694-698. 10.4070/kcj.2013.43.10.694.

A Case of Three Consecutive Events of Acute Myocardial Infarctions in Three Different Vessels

• Yang H
• Her SH
• Park MW
• Cho JS
• Kim CJ
• Kwon JB
• Ro SM
• Park YK

• KMID: 1826561
• DOI: http://doi.org/10.4070/kcj.2013.43.10.694

Abstract

A 51-year-old man was being admitted to the emergency department with chest pains. He had a history of acute myocardial infarction (MI) on two prior occasions and was successfully treated with drug eluting stents. He was diagnosed with 3 consecutive events of acute MI in 3 different vessels. The consecutive events of acute MI in different vessels are a very rare case. He did not have risk factors, such as coagulation abnormality, clopidogrel resistance, patient's compliance and vessel abnormality, except for his cigarette smoking. We reported the first case with 3 consecutive events of acute MI in each 3 vessels during a long-term interval.

Keyword

Myocardial infarction; Coronary vessels; Thrombosis

MeSH Terms

Chest Pain
Coronary Vessels
Drug-Eluting Stents
Emergencies
Humans
Middle Aged
Myocardial Infarction*
Risk Factors
Smoking
Thrombosis

Figure

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  Fig. 1 ECG on February 21, 2000. The ECG shows ST-segment elevation in the inferior leads (II and aVF) and the anterior (V 2-4) leads. ECG: electrocardiogram.

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  Fig. 2 ECG on December 30, 2007. The ECG shows ST-segment elevation in the inferior (II, III, and aVF) leads. ECG: electrocardiogram.

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  Fig. 3-1 Right coronary angiography on December 30, 2007. A: the initial coronary angiography shows a total occlusion with thrombus and TIMI 0 distal flow in the mid portion of the RCA (white arrow). B: the post stent coronary angiography shows TIMI 3 distal flow in the RCA, which is successfully treated with a paclitaxel eluting stent (white arrow). TIMI: Thrombolysis in Myocardial Infarction, RCA: right coronary artery.

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  Fig. 3-2 Coronary angiography on December 30, 2007. A right anterior oblique view. A: the initial coronary angiography shows a 95% restenosis in stent with thrombus and TIMI 0 distal flow in the proximal portion of the LAD (white arrow). B: the post stent coronary angiography shows TIMI 3 distal flow in the LAD, which is successfully treated with a zotarolimus eluting stent (black arrow) and overlapping a sirolimus eluting stent (white arrow). TIMI: Thrombolysis in Myocardial Infarction, LAD: left anterior descending coronary artery.

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  Fig. 4 ECG on September 25, 2012. The ECG shows Q-wave and ST elevation in V 1-5 and T-inversion in V 4-6. ECG: electrocardiogram.

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  Fig. 5 Coronary angiography on September 25, 2012. A left anterior oblique view. A: the initial coronary angiography shows a total occlusion with thrombus and TIMI 0 distal flow in the proximal portion of the LCX (white arrow). B: the post stent coronary angiography shows TIMI 3 distal flow in the LCX, which is successfully treated with a zotarolimus eluting stent (white arrow). TIMI: Thrombolysis in Myocardial Infarction, LCX: left circumflex coronary artery.

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