MULTIPLE ATHEROSCLEROTIC PLAQUE RUPTURE IN ACUTE MYOCARDIAL INFARCTION.
Multiple atherosclerotic plaque rupture in acute myocardial infarction.
DOI:
https://doi.org/10.59722/rmcu.v3i1.963Keywords:
Acute myocardial infarction, Thrombosis, Cardiogenic shockAbstract
In most cases of acute myocardial infarction, initial event is the rupture of an atherosclerotic plaque in one of three main epicardial coronary arteries. However, in a minority of cases, atherosclerotic plaque rupture may occur in more than one epicardial coronary artery. We present the case of a 69-year-old male patient, with acute myocardial infarction and cardiogenic shock, with thrombosis in the left main coronary artery and right coronary artery.
Key words: acute myocardial infarction, thrombosis, cardiogenic shock
Downloads
References
Scirica B, Libby P, Morrow D. ST-Elevation Myocardial Infarction. En: Zipes D, Libby P, Bonow R, Mann D, Tomaselli G, Braunwald E, editores. Braunwald´s Heart Disease, a Textbook of Cardiovascular Medicine, Eleventh Edition. Philadelphia: Elsevier. 2019. pp 1097.
Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-3826. Disponible en: https://doi.org/10.1093/eurheartj/ehad191
Hong MK, Mintz G, Lee CW, Kim YH, Lee SW, Song JM, et al. Comparison of Coronary Plaque Rupture Between Stable Angina and Acute Myocardial Infarction: A Three-Vessel Intravascular Ultrasound Study in 235 Patients. Circulation. 2004;110:928-933. Disponible en: https://doi.org/10.1161/01.CIR.0000139858.69915.2E
Arbab-Zadeh A, Fuster V. The Myth of the “Vulnerable Plaque.” J Am Coll Cardiol. 2015 Mar 3; 65(8): 846–855. Disponible en: https://doi.org/10.1016/j.jacc.2014.11.041
Kubo T, Imanishi T, Kashiwagi M, Ikejima H, Tsujioka H, Kuroi A, et al. Multiple Coronary Lesion Instability in Patients With Acute Myocardial Infarction as Determined by Optical Coherence Tomography. Am J Cardiol 2010 Feb 1;105(3):318-22. Disponible en: https://doi.org/10.1016/j.amjcard.2009.09.032
Dönmez Y, Acele A, Köse Z. Acute Myocardial Infarction Due to Multiple Thrombosis without Cardiogenic Shock. Med Princ Pract 2019;28:87–90. Disponible en: https://doi.org/10.1159/000495004
Choudary S. Acute Myocardial Infarction with Simultaneous Involvement of Right Coronary Artery and Left Anterior Descending Artery: A Case Report. Arch Med. 2015, 8:1. Disponible en: https://doi.org/10.1016/S1607-551X(10)70063-2
Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O’Neill WW. Multiple Complex Coronary Plaques in Patients with Acute Myocardial Infarction. N Engl J Med 2000;343:915-22. Disponible en: https://doi.org/10.1056/NEJM200009283431303
Burke A, Virmani R. Significance of multiple coronary artery thrombi. A consequence of diffuse atherosclerotic disease? Ital Heart J. 2000 Dec;1(12):832-4. Recuperado de Crea F, Kolodgie F, Finn A, Virmani R. Mechanisms of acute coronary syndromes related to atherosclerosis. Uptodate. Jul 11, 2018.
Pollak PM, Parikh SV, Kizilgul M, Keeley EC. Multiple Culprit Arteries in Patients With ST Segment Elevation Myocardial Infarction Referred for Primary Percutaneous Coronary Intervention. Am J Cardiol 2009;104:619–623. Disponible en: https://doi.org/10.1016/j.amjcard.2009.04.053
Kim S, Seol SH, Park DH, Song YS, Kim DK, Kim KH, et al. Simultaneous multiple coronary arteries thrombosis in patients with STEMI. J Geriatr Cardiol 2018,15(3):241-243. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC5919814/
Tanaka A, Shimada K, Sano T, Namba M, Sakamoto T, Nishida Y, et al. Multiple Plaque Rupture and C-Reactive Protein in Acute Myocardial Infarction. J Am Coll Cardiol 2005;45:1594 –9. Disponible en: https://doi.org/10.1016/j.jacc.2005.01.053
Xie Y, Mintz GS, Yang J, Doi H, Iñiguez A, Dangas GD, et al. Clinical Outcome of Nonculprit Plaque Ruptures in Patients With Acute Coronary Syndrome in the PROSPECT Study. JACC Cardiovasc Imaging. 2014 Apr;7(4):397-405. Disponible en: https://doi.org/10.1016/j.jcmg.2013.10.010
Sarmiento RA, Blanco F, Parisi C, Riccitelli MA, Gigena G, Gagliardi JA. Inestabilidad en multiples placas ateroscleróticas en pacientes fallecidos por infarto agudo de Miocardio. Medicina 2011; 71(4):317-322.
Ibáñez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. Guía ESC 2017 sobre el tratamiento del infarto agudo de miocardio en pacientes con elevación del segmento ST. Rev Esp Cardiol. 2017;70(12):1082.e1-e61. Disponible en: https://doi.org/10.1093/eurheartj/ehx393
Moura-Ferreira S, Ladeiras-Lopes R, Mbala D, Rodrigues A, Braga P, Gama V. The role of Impella in high-risk percutaneous coronary intervention. Rev Port Cardiol. 2018;37(7):623.e1---623.e4. Disponible en: https://doi.org/10.1016/j.repc.2017.05.013
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Revista Médico Científica UNACHI
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Esta obra está bajo una Licencia Creative Commons Atribución-NoComercial 4.0 Internacional.
