Korean J Med.  2004 Sep;67(3):311-316.

A case of acute anterior and lateral myocardial infarction altering with time from a large intracoronary thrombus on left main trunk

• Lee YS
• Hur SH
• Hyun DW
• Han SW
• Kim KS
• Kim YN
• Kim KB

Abstract

Plaque rupture is one of the main causes of acute myocardial infarction. Especially when the thrombus is located in the left main trunk coronary artery, it can effect the left anterior descending as well as circumflex coronary artery, resulting in myocardial necrosis of the anterior and lateral wall. Usually acute myocardial infarction due to left main trunk coronary artery occlusion occurs simultaneously in both anterior and lateral ST-segment elevation, associated with cardiogenic shock. However, rarely does the region alter with time. We report a 59-year old male who had been diagnosed with anterior wall acute myocardial infarction at a local hospital, but on transferral to our hospital 4 hours later, was diagnosed with lateral wall acute myocardial infarction based on electrocardiogram changes. Coronary angiography revealed a mobile, large thrombus on left main trunk with TIMI 3 flow. After heparinization for 5 days, follow-up coronary angiography revealed a complete resolution of previous thrombus.

Keyword

Thrombus; Coronary artery; Acute myocardial infarction

MeSH Terms

Coronary Angiography
Coronary Vessels
Electrocardiography
Follow-Up Studies
Heparin
Humans
Male
Middle Aged
Myocardial Infarction*
Necrosis
Rupture
Shock, Cardiogenic
Thrombosis*
Heparin