Acute myocardial infarction caused by simultaneous occlusion of the right coronary artery and the left anterior descending coronary artery probably due to coronary spasm: a case report.

摘要

A 56-year-old man had an attack of chest pain associated with ST-segment elevation in both the inferolateral and anteroseptal leads on electrocardiography. Emergency coronary angiography showed thrombus in the mid right coronary artery and total occlusion in the distal left anterior descending coronary artery. Intravenous heparin infusion and antiplatelet therapy were given without other coronary intervention. After 1 week, repeat coronary angiography showed neither significant stenosis nor thrombus in the coronary arteries. Severe coronary artery spasm in the left coronary artery was induced by the provocation test with intracoronary injection of 50 microg acetylcholine. He had an uneventful hospital course. This unique case demonstrated intracoronary thrombus formation in the right coronary artery and left anterior descending coronary artery simultaneously due to suspected coronary spasm.