Radiology Case Reports (Mar 2023)

Simultaneous total occlusion of the 3 major coronary arteries in a patient with inferior ST-segment elevation myocardial infarction complicated by cardiogenic shock and sinus bradycardia

  • Mohammed El-Azrak, MD,
  • Mohammed Boutaybi, MD,
  • Noha El Ouafi, MD,
  • Zakaria Bazid, MD

Journal volume & issue
Vol. 18, no. 3
pp. 1345 – 1348

Abstract

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Simultaneous occlusion of more than one coronary artery is uncommon and associated with poor prognosis. We reported a particular case of a 62-year-old patient, who presented with an inferior ST-segment elevation myocardial infarction with right ventricular involvement complicated by cardiogenic shock, sinus bradycardia, and an extensive echocardiographic ischemia with severe left ventricular systolic dysfunction. Coronary angiography revealed occlusion of 3 major coronary arteries. Primary percutaneous coronary intervention of the right coronary artery was performed with hemodynamic recovery, chest pain, and ST-segment resolution. Treatment for heart failure with reduced ejection fraction was initiated, with a good outcome.

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