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- Title
Acute Inferior Myocardial Infarction due to Occlussion of the Left Coronary Artery Originating from Right Ostium of the Aorta.
- Authors
Topuz, Mustafa; Gur, Mustafa; Caylı, Murat; Can, Çağdaş; Topuz, Ayse Nur
- Abstract
Introduction: Acute occlusion of the left anterior descending coronary artery generally results in ST segment elevations in precordial leads and reciprocal ST segment depression in inferior leads. The occurrence of isolated inferior myocardial infarction due to occlusion of LAD is very rare. In this case we report an isolated inferior myocardial infarction and reciprocal ST segment depression in anterior leads due to occlusion of left anterior descending coronary artery that supplies the inferior wall of left ventricle via collateral flow to the right coronary artery. Case report: A 78-year-old woman was admitted to emergency department with retrosternal chest pain for two hours. The initial electrocardiogram on emergency department demonstrated changes consistent with an acute inferior wall ST elevation myocardial infarction with ST depression on anterior leads. The angiogram demonstrated the RCA was totally obstructed from under right ventricle branch and there was no left coronary ostium. We find the LMCA originated near ostium of the RCA. LMCA angiography showed a subtotal lesion with thrombus in the mid segment left anterior descending artery. Post deployment angiography showed good result with TIMI III flow and no residual stenosis. Patient was discharged on aspirin 300 mg/day, clopidogrel 75 mg/day, metoprolol 50 mg/day, ramipril 2.5 mg/day and atorvastatin 40 mg/day. Conclusion: This case was an unusual variety of wrapped LADs where the entire posterior descending artery was formed by continuation of the distal LAD. The occlusion was distal to all diagonal branches and hence resulted in isolated inferior wall MI without anterior wall changes. This case report emphasizes that, the coronary intervention must be planned after all angiographic images are accured.
- Subjects
BLOOD-vessel abnormalities; ELECTROCARDIOGRAPHY; MYOCARDIAL infarction; MYOCARDIAL revascularization; SURGICAL stents; TRANSLUMINAL angioplasty; CORONARY angiography; DIAGNOSIS
- Publication
International Medical Journal, 2016, Vol 23, Issue 6, p681
- ISSN
1341-2051
- Publication type
Article