Abstract
Acute myocardial infarction is usually caused by rupture of unstable plaque and involves a single coronary artery. Simultaneous occlusions of multiple coronary arteries in patients with ST elevation myocardial infarction are uncommon and lead to a fatal outcome. We report a 75-year-old male presenting with persistent chest pain complicated by ventricular fibrillation. After defibrillation and cardiopulmonary resuscitation, an emergency coronary angiogram showed total occlusion of the right coronary artery, and thrombus in the proximal left anterior descending artery. Both coronary arteries underwent successful balloon inflation and stenting. The patient finally survived under ventilatory support. This rare case suggests that aggressive reperfusion therapy and even mechanical support to improve poor clinical outcome are suggested in high risk patients with multivessel occlusions.