“Double Myocardial Infarct Syndrome” resulting from Simultaneous Occlusion of Dual Coronary Arteries: A Double Jeopardy

Abstract

Angiographic evidence of thrombosis in more than one coronary artery at the same time is uncommon in patients with acute myocardial infarction, and this is hard to identify with routine electrocardiography. Patients may manifest with high-degree atrioventricular block, cardiogenic shock, or sudden cardiac arrest, all of which are potentially fatal outcomes. This case study focuses on a patient who experienced cardiogenic shock, high-degree atrioventricular block secondary to acute anterior-inferior ST-segment elevation myocardial infarction. During the coronary angiogram, thrombotic occlusions of the left anterior descending and right coronary arteries were observed. A patient was salvaged by the use of mechanical circulatory assistance in conjunction with prompt percutaneous coronary intervention of both the culprit arteries. Our case report emphasizes the importance of completing revascularization as soon as possible by opening the culprit arteries and ensuring appropriate mechanical circulatory support to the patient.