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Multivessel acute coronary thrombosis and occlusion--an unusual cause of cardiogenic shock

Yoav Turgeman1, Khaled Suleiman, Shaul Atar

  • 1Department of Cardiology, Ha'Emek Medical Center, Afula, Israel.

The Journal of Invasive Cardiology
|September 11, 2007
PubMed

Insights

A patient with cardiogenic shock developed multivessel thrombus due to a single artery blockage. Thrombus aspiration was the primary treatment for this rare condition.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Thrombosis

Background:

  • ST-elevation myocardial infarction (STEMI) with cardiogenic shock is a critical condition.
  • Acute coronary syndromes often involve thrombotic occlusion of a single coronary artery.

Observation:

  • A 44-year-old male presented with STEMI and cardiogenic shock.
  • Coronary angiography revealed acute thrombotic occlusion in the left anterior descending artery (LAD) and right coronary artery, with additional thrombi in the circumflex artery.

Findings:

  • The patient was treated with multivessel thrombus aspiration and intra-aortic balloon pump.
  • Intravascular ultrasound revealed only mild disease in the LAD one week post-treatment.
  • This suggests plaque rupture in a single artery can cause low coronary perfusion, leading to widespread thrombus formation.

Implications:

  • Multivessel thrombus formation secondary to single-vessel plaque rupture is a rare but plausible complication in cardiogenic shock.
  • Thrombus aspiration should be considered the primary therapeutic strategy in such unique clinical scenarios.

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