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- Title
STENTATION IN LEFT ANTERIOR DESCENDING CORONARY ARTERY OBSTRUCTION, "WIDOWMAKER" HEART ATTACK.
- Authors
Macarescu, Andrei; Gabroveanu, Elena-Diana; Iliescu, Adrian-Alexandru; Balasa, Amanda; Turcoman, Paul
- Abstract
Background: A "widowmaker" heart attack is a type of heart attack that is caused by a total blockage of the left anterior descending (LAD) artery. The LAD artery the largest coronary artery, being considered the most important because it supplies over half of the heart muscle with blood. If blocked, the heart stops fast. Objective: Evaluation of the coronary arteries obstruction in the shortest time possible through coronarography, performing an angioplasty, stenting and restoring blood flow in the obstructed area of the artery. Materials and methods: Female, 60-years-old diabetic-hypertensive patient is admitted to the emergency room with typical precordial pain, ST segment elevation in V1-V4 and presenting reactive myocardial necrotic enzymes. Ultrasound evaluation shows severely impaired systolic function of the left ventricle with ejection fraction of 12-13%. Before coronarography, the patient presents three sustained ventricular tachycardic episodes without pulse, the pulse being re-established through defibrillation. Results: A femoral artery approach was used. A direct catheter was cannulated and the anterior descending coronary artery (LAD) dilated in order to restore the flow in the segment. A stenting procedure in the ostium of same segment was used. After stenting with thrombotic occlusion of LAD at the level of segment II, a thromboaspiration was performed, resuming the blood flow distally. Additionally, a significant stenosis was detected on LAD segment II, the stenosis being dilated and then stented. The stents were successfully placed, blood flow resuming on LAD. However, the patient died a few hours later due to extremely reduced myocardial flow reserve. Conclusions: In such situations, ridding the vessel of obstruction is the only solution. However, the chances of survival depend on the patient's overall state.
- Subjects
MYOCARDIAL infarction; ARTERIAL occlusions; FEMORAL artery; BLOOD flow; MYOCARDIUM; CORONARY arteries
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p35
- ISSN
2068-3324
- Publication type
Article