Primary stenting of the left main coronary artery in acute myocardial infarction complicated by cardiogenic shock: case report.

Abstract

Although acute left main coronary artery (LMCA) occlusion is a rare angiographic finding, it carries a very high mortality rate and most of the patients with this clinical condition die from sudden death or cardiogenic shock due to malignant arrhythmia or pump failure. The high mortality rate and tendency to lead rapidly to death are chiefly related to extensive myocardial injury. We report a case of cardiogenic shock resulting from acute myocardial infarction. Emergency cardiac catheterization was performed and coronary angiography showed a totally occluded LMCA. Prompt revascularization by means of primary LMCA stenting was successful and the patient was discharged 2 weeks later with only mild congestive heart failure. We suggest that the rapid performance of angiographic studies in this patient with cardiogenic shock was the turning point in saving her life. We also suggest primary LMCA stenting as an effective procedure for saving lives because it may reverse cardiogenic shock and prevent a probable fatal outcome.