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American Journal of Medical Case Reports. 2021, 9(3), 190-193
DOI: 10.12691/AJMCR-9-3-14
Case Report

Inferior ST-segment Elevation Myocardial Infarction due to a Proximal “Wrap around” Left Anterior Descending Coronary Artery Occlusion: A Case Report

Pramod Theetha Kariyanna1, Shamna Mohammed2, 3, Ruchi Yadav3, Ashkan Tadayoni4, Apoorva Jayarangaiah5 and Isabel M. McFarlane4,

1Division of Interventional Cardiology, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel Hospitals, New York City, NY-10025, U.S.A.

2Department of Internal Medicine, Baptist Health Medical Center, Little Rock, AR 72205, U.S.A.

3Department of Internal Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY 11212, USA.

4Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203, U.S.A.

5Department of Internal Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, N.Y., U.S.A.

Pub. Date: January 14, 2021
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Cite this paper

Pramod Theetha Kariyanna, Shamna Mohammed, Ruchi Yadav, Ashkan Tadayoni, Apoorva Jayarangaiah and Isabel M. McFarlane. Inferior ST-segment Elevation Myocardial Infarction due to a Proximal “Wrap around” Left Anterior Descending Coronary Artery Occlusion: A Case Report. American Journal of Medical Case Reports. 2021; 9(3):190-193. doi: 10.12691/AJMCR-9-3-14

Abstract

Inferior ST-segment myocardial infarction (STEMI) is often due to acute occlusion of the right coronary artery (RCA) or left circumflex artery (LCx). Anatomically, distal occlusion of a dominant left anterior descending artery (LAD) wrapping around the apex supplying posterior descending artery (PDA) can also lead to inferior wall MI. The occurrence of inferior MI with LAD occlusion is underappreciated. We are presenting a case of proximal LAD occlusion leading to inferior wall MI in the presence of non-occlusive right coronary artery (RCA). Physicians should keep in mind the possibility of inferior myocardial infarction with LAD occlusion and interventional cardiologists should perform a complete angiogram to identify the faulty lesion in inferior STEMI before deciding on a RCA or LCx as the culprit artery. Isolated IWMI (inferior wall myocardial infarction) from proximal occlusion of the wrapped around LAD as noted in our patient is a rare occurrence.

Keywords

acute ST segment elevation myocardial infarction, left anterior descending coronary artery, wrapped around LAD, inferior wall myocardial infarction

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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