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A Case with a History of Acute Myocardial Infarction on four Separate Occasions and with Total Occlusion of the three Main Coronary Arteries Shinobu Hosokawa 1 , Yoshikazu Hiasa 1 , Shinji Harada 1 , Takefumi Takahashi 1 , Satoshi Kato 1 , Koichi Kishi 1 , Masato Tanimoto 1 , Ryuji Ohtani 1 1Division of Cardiology, Komatsushima Red Cross Hospital Keyword: 急性心筋梗塞 , 冠動脈3枝完全閉塞 , 左室駆出率 , 高齢者 , acute myocardial infarction , total occlusion of three coronary arteries , left ventricular ejection fraction pp.1237-1241
Published Date 1997/12/15
DOI https://doi.org/10.11477/mf.1404910085
  • Abstract
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We report a rare case of an aged patient who has suffered from acute myocardial infarction four times over a 10-year-period and is still alive. The patient, a 78 -year-old man, has a history of an acute miocardial infarction of the anterior area in 1987, of the inferior area in 1990 and of the high lateral area in 1991. In 1996, he consulted us because of an oppressive sensation of the anterior chest. His electrocardiography revealed ST eleviation in V1-6 and aVL The coronary angiography in the chronic stage showed complete occlusion in a loca-tion just proximal to the three major coronary branches. These involve the collateral circulation from the large obtuse marginal artery to the left anterior descending artery branch and to the right coronary artery. The right coronary artery has also bridge collateral circula-tion. The left ventricular ejection fraction was 22%. The patient and his family have rejected invasive therapies such as PTCA or CABG. We suggest that, in this case,well-developed collateral circulation and the patient's long history of an ischemic condition may make it possible for him to survive under these severe circum-stances.


Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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