A rare case of concomitant acute occlusion of left main coronary artery and right coronary artery with characteristic electrocardiographic pattern
Article Sidebar
Main Article Content
Abstract
Acute Left Main Coronary Artery (LMCA) occlusion is a rare clinical presentation which often manifests as a cardiogenic shock with worse prognosis. However, the clinical outcome depends on the age of the patient, co-morbidities, the patency and dominancy of Right coronary artery. Since LMCA supplies a large myocardial territory of left ventricle, it shows a characteristic Electrocardiographic (ECG) pattern which helps to an early diagnosis. Presence of ST elevation in aVR with ST depressions of more than six leads is highly characteristic for LMCA occlusion. Here we are reporting an extremely rare case of acute concomitant occlusion of LMCA and Right coronary artery manifesting as a cardiogenic shock with ST elevation in aVR ,V1,III, aVF leads with ST depressions in all other leads. Patient showed excellent clinical outcome and reversal of characteristic ECG pattern following Percutaneous Coronary Intervention (PCI) to the culprit vessels.
Downloads
Article Details
Copyright (c) 2021 Jayasekara T, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.
We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.
Peertechz accomplice with- [CC BY 4.0]
Explanation
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:
|
License Name |
Permission to read and download |
Permission to display in a repository |
Permission to translate |
Commercial uses of manuscript |
|
CC BY 4.0 |
Yes |
Yes |
Yes |
Yes |
The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.
Quigley RL, Milano CA, Smith LR, White WD, Rankin JS, et al. (1993) Prognosis and management of anterolateral myocardial infarction in patients with severe left main disease and cardiogenic shock. The left main shock syndrome. Circulation 88: II65-70. Link: https://bit.ly/3u2F8eW
Gorgels APM, Engelen DJM, Wellens HJJ (2001) Lead aVR, a mostly ignored but very valuable lead in clinical electrocardiography. J Am Coll Cardiol 38: 1355-1356. Link: https://bit.ly/3dfydZQ
Nikus KC, Eskola MJ (2008) Electrocardiogram patterns in acute left main coronary artery occlusion. J Electrocardiol 41: 626-629. Link: https://bit.ly/3baLqR3
Yamaji H, Iwasaki K, Kusachi S, Murakami T, Hirami R, et al. (2001) Prediction of acute left main coronary artery obstruction by 12-lead electrocardiography. J Am Coll Cardiol 38: 1348-1354. Link: https://bit.ly/3jNS5nU
Engelen DJ, Gorgels AP, Cheriex EC, De Muinck ED, Ophuis AJ, et al. (1999) Value of the electrocardiogram in localizing the occlusion site in the left anterior descending coronary artery in acute anterior myocardial infarction. J Am Coll Cardiol 34: 389-395. Link: https://bit.ly/3puhyEp
De Luca G, Suryapranata H, Thomas K, van 't Hof AW, de Boer MJ, et al. (2003) Outcome in patients treated with primary angioplasty for acute myocardial infarction due to left main coronary artery occlusion. Am J Cardiol 91: 235-238. Link: https://bit.ly/3al1z7h
Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, et al. (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction executive summary: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 110: 588-636. Link: https://bit.ly/3dePG4k
Serruys PW, Morice MC, Kappentein AP, Colombo A, Holmes DR, et al. (2009) Percutaneous coronary interventions versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 360: 961-972. Link: https://bit.ly/37eXwXQ