Acute occlusion of the left main trunk presenting as ST-elevation acute coronary syndrome

Total occlusion of the left main coronary artery presenting as ST-elevation myocardial infarction

An ECG pattern of widespread ST depression in six or more precordial and inferior leads, accompanied by ST-segment elevation in the aVR and/or V₁ leads, is typical of the non-ST-segment elevation myocardial infarction (NSTEMI) pattern associated left main (LM) artery occlusion, but this ECG pattern is really associated with a subocclusion of the LM, or in the case that the LM was occluded with the presence of collateral circulation. There are few reports of ST-elevation myocardial infarction (STEMI) due to acute total LM occlusion. We report a case of STEMI pattern due to acute total LM occlusion.

Acute total occlusion of the left main coronary artery treated with percutaneous intervention and simultaneous implantation of intra-aortic balloon pump

Electrocardiographic findings at first medical contact and direct transfer to the catheterization laboratory are important in acute total occlusion of the left main coronary artery. Simultaneous emergency angioplasty and intra‐aortic balloon pump implantation might be beneficial in overcoming the patient's most critical hemodynamic instability.