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When the innocent bystander becomes the culprit: A case report of | 54327
Clinical & Experimental Cardiology

Clinical & Experimental Cardiology
Open Access

ISSN: 2155-9880

+44 1300 500008

When the innocent bystander becomes the culprit: A case report of two episodes of ST-elevation myocardial infarction with different culprit coronary arteries in a single patient occurring two days apart


Global Summit on Heart Diseases and Therapeutics

October 20-21, 2016 Chicago, USA

Aileen D M Divinagracia-Alban and Benjamin N Alimurung

Makati Medical Center, Philippines

Posters & Accepted Abstracts: J Clin Exp Cardiolog

Abstract :

Background: Recurrent ST elevation myocardial infarction (STEMI) with different culprit lesions in a single patient occurring few days apart is very rare with limited similar cases reported. Case Presentation: We present a case of a 53-year-old male who presented to the Emergency department with left upper quadrant abdominal pain and an initial electrocardiogram showing ST elevation MI in the anterolateral leads. He underwent successful primary angioplasty of the culprit lesion (LAD) with placement of a single everolimus drug-eluting stent with plans for staged intervention within a month of the remaining severe lesion in the left circumflex (LCx) artery (non-infarct related vessel). Two days after the initial STEMI, the patient experienced recurrence of abdominal pain with hypotension, and a repeat ECG revealed new ST segment elevation in the inferior leads. A repeat coronary angiogram demonstrated a widely patent stent in the LAD and the previously noted diseased LCx. No other new lesions were noted and the RCA was also patent. The patient then underwent a successful second primary PCI of the previously untreated severe lesion in the LCx. Conclusion: Consecutive episodes of acute myocardial infarction in different coronary arteries occurring within hours to a few days after primary PCI for STEMI is very rare and can be catastrophic if not detected early. The preferred interventional treatment strategy as to whether we need to perform â�?�?culprit-lesion onlyâ�? versus â�?�?preventiveâ�? PCI of all significant lesions in STEMI patients with multivessel disease remains controversial.

Biography :

Aileen D M Divinagracia-Alban has completed her Doctor of Medicine and Internship from the University of Santo Tomas. She took up Residency Training in Internal Medicine from Makati Medical Center. She is currently a third year Cardiology Fellow in Makati Medical Center, Philippines.

Email: aileen.divinagracia@yahoo.com

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