Cor Vasa 2003, 44(11):551-555

PTCA of left main occlusion in a patient in cardiogenic shock complicating anterior myocardial infarction. Two-year follow-up

Sławomir Dobrzycki¹, Przemysław Prokopczuk^1,*, Wacław Kochman¹, Bronisław Czech², Paweł Kralisz¹, Ewa Kucewicz-Czech³, Grzegorz Juszczyk³, Konrad Nowak¹

¹ Oddělení invazivní kardiologie

² Oddělení kardiochirurgie

³ Oddělení anesteziologie a intenzivní péče, Vojenská akademie, Bialystok, Polsko

Cardiogenic shock is the most serious hemodynamic complication of acute myocardial infarction (AMI). Currently, it occurs in 5-10% of patients with AMI. Cardiogenic shock results in high mortality, ranging from 35% up to 100%, depending on the treatment used. Most often, it occurs in cases of acute occlusion of the left anterior descending artery (LAD) or the left main coronary artery (LMCA), leading to myocardial infarction that involves large areas of the left ventricle. Nevertheless, acute occlusion of the proximal part of a dominant right coronary artery or circumflex artery may also be the cause of this complication. This paper reports successful treatment of a patient with acute anterior AMI complicated by cardiogenic shock, admitted to a local cardiac center in order to perform urgent invasive diagnosis and treatment. Right after the admission, asystoly occurred and successful cardiopulmonary resuscitation (CPR) was conducted; afterwards, coronary angiography was performed. The coronary angiography showed occlusion of the LMCA. Successful primary percutaneous coronary intervention (PCI) of the occluded LMCA was performed immediately after the coronary angiography. Patient was observed for the next 2 years. Two years after the primary PTCA procedure, he presents with mild symptoms of angina pectoris (I class according to CCS) and symptoms of congestive heart failure (III functional class according to NYHA).

Keywords: Angioplasty; Myocardial infarction; Cardiogenic shock

Published: November 1, 2003  Show citation