Immediate Rupture of Another Coronary Plaque After PCI of the Culprit Lesion in ST Segment Elevation Myocardial Infarction

Abstract

ST-segment elevation myocardial infarction (STEMI) is usually the result of thrombosis in the single coronary artery. The incidence of multiple coronary artery thrombosis in acutephase is very low. The etiology of multivessel coronary thrombosis is still unclear. Observationalstudies have shown that plaque instability underlying thrombosis is not due to local vascular causesalone. These pathophysiological processes such as inflammation, sympathic activity and catecholamines discharge act across the entire coronary network and cause multiple plaque instability.1,2We think that the pathogenesis of multiple coronary occlusive lesions may be explained by multiple atherosclerotic plaque rupture during the acute phase of myocardial infarction. In our case, thefirst percutaneous coronary intervention was performed on the left anterior descending artery dueto anterior STEMI. At the second hour of follow-up, inferior STEMI developed and percutaneouscoronary intervention was performed on optus marginalis.