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KMID : 0882420040670030311
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Korean Journal of Medicine
2004 Volume.67 No. 3 p.311 ~ p.316
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A case of acute anterior and lateral myocardial infarction altering with time from a large intracoronary thrombus on left main trunk
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Lee Young-Soo
Hur Seung-Ho
Hyun Dae-Woo
Han Seong-Wook
Kim Kee-Sik
Kim Yoon-Nyun
Kim Kwon-Bae
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Abstract
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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.
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KEYWORD
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Thrombus, Coronary artery, Acute myocardial infarction
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