Double Culprit Coronary Arteries in ST Elevation Myocardial Infarction Treated with Primary Percutaneous Intervention: A Case Report

Author : H.H. Satoto, R. Puspitoadhi, R.A. Raharjo, S. Sungkar, I. Uddin
Upload Date : 19-04-2018

Background: In most cases of acute ST-segment elevation myocardial infarction have only one epicardial artery contains an occluding thrombus, commonly referred to as the “culprit” artery. It is rare for patients who presenting with more than one acutely thrombosed coronary artery. 

Case presentation: A 57-year-old man admitted to the emergency department with typical chest pain for 4-hour. The cardiovascular risk factors were uncontrolled diabetes mellitus and hypertension, and electrocardiogram showed an elevation in II, III, aVF, V7-9 and ST-segment depression in V2-4, I, and aVL. He was planned and prepared to primary percutaneous intervention. During coronary angiography, there was two thrombosed coronary arteries with hazy appearance, in the right coronary artery and left circumflex artery. Both of them are thrombus type lesions. Four drug eluting stents in total was placed in the culprit arteries, three in the right coronary artery and one in the left circumflex artery. There was a lesion in the left anterior descending artery, but not a thrombus type one. The patient didn’t complain any chest pain and hemodynamically stable in the intensive cardiac care unit after primary percutaneous intervention.

Conclusion: We describe a rare ST-segment elevation myocardial infarction with double culprit coronary arteries. Both of them were treated with primary percutaneous intervention.

KEYWORDS : double culprit, ST-segment elevation myocardial infarction

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