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Case Reports
. 2023 Mar 24;15(3):e36616.
doi: 10.7759/cureus.36616. eCollection 2023 Mar.

Double the Trouble - One Infarction After Another: A Case Report of Two Consecutive ST-Segment Elevation Myocardial Infarctions in Two Different Coronary Arteries

Zineb Agoumy  1 , Kaoutar Berrag  1 , Aida Soufiani  1 , Nesma Bendagha  1 , Rokya Fellat  1
Affiliations
Case Reports

Double the Trouble - One Infarction After Another: A Case Report of Two Consecutive ST-Segment Elevation Myocardial Infarctions in Two Different Coronary Arteries

Zineb Agoumy et al. Cureus. .

Abstract

In multi-vessel coronary artery disease, concomitant ST-segment elevation myocardial infarction (STEMI) in simultaneous two culprit lesions have been rarely reported. In this regard, the recurrence in a short period of time of a STEMI in a different coronary artery is also rare. We describe the case of a 56-year-old male smoker, who was presented with an anterior STEMI. The coronary angiography demonstrated a significant lesion in the left main coronary (LMC) and an occlusion of the left anterior descending artery (LAD), and was referred for surgery. Four days later, he experienced symptoms of acute ischemia of the inferior territory. A newly formed culprit lesion of the circumflex artery (Cx) was detected and benefited from angioplasty. The patient expired the next day from sudden arrythmia. This case report shows two consecutive STEMI situations in separate coronary arteries, which commonly can occur in atherosclerotic patients with very poor prognosis.

Keywords: coronarography; coronary arteries; culprit lesion; myocardial infarction; recurrent stemi.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Admission EKG that showing a clear ST-segment elevation in the anterior leads.
EKG, electrocardiogram
Figure 2
Figure 2. Coronary angiogram on admission in RAO view showing a stenosis of the LMC and a calcified obstruction of the LAD.
LMC, left main coronary; LAD, left anterior descending artery
Figure 3
Figure 3. Coronary angiogram on admission in LAO view showing a chronic occlusion of the RCA.
RCA, right coronary artery
Figure 4
Figure 4. EKG after a few days showing ST segment elevation in the inferior leads.
EKG, electrocardiogram
Figure 5
Figure 5. Coronary angiogram is RAO view showing a recent obstructive lesion of the Cx.
Cx, circumflex artery
Figure 6
Figure 6. Angiography results after stunting.
See this image and copyright information in PMC

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