Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock

Total occlusion of the left main coronary artery (LMCA) is a rare but highly lethal event in acute coronary syndrome. It can lead to extensive myocardial infarction and hemodynamic instability. Despite advancements in percutaneous coronary intervention (PCI), mortality remains high. A 35-year-old ma...

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Main Authors: Lagaputi Rama Rao, Silpa Chowdari Nallapaneni, Naga Sri Haritha Parvathaneni, Akif Ahamad Baig, Bikash Sahu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Heart India
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Online Access:https://journals.lww.com/10.4103/heartindia.heartindia_42_24
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author Lagaputi Rama Rao
Silpa Chowdari Nallapaneni
Naga Sri Haritha Parvathaneni
Akif Ahamad Baig
Bikash Sahu
author_facet Lagaputi Rama Rao
Silpa Chowdari Nallapaneni
Naga Sri Haritha Parvathaneni
Akif Ahamad Baig
Bikash Sahu
author_sort Lagaputi Rama Rao
collection DOAJ
description Total occlusion of the left main coronary artery (LMCA) is a rare but highly lethal event in acute coronary syndrome. It can lead to extensive myocardial infarction and hemodynamic instability. Despite advancements in percutaneous coronary intervention (PCI), mortality remains high. A 35-year-old male presented with chest pain, dyspnea, and hemodynamic instability. Diagnostic workup revealed LMCA thrombotic occlusion with extensive myocardial involvement and cardiogenic shock (CS). Prompt intervention, including thrombus aspiration, angioplasty, and hemodynamic support with intra-aortic balloon pump and venoarterial extracorporeal membrane oxygenation, was initiated. The patient’s condition gradually improved with comprehensive management, including pharmacotherapy and intensive care support. LMCA occlusion presents challenges due to its extensive myocardial distribution and high mortality rates, particularly when complicated by CS. PCI combined with circulatory support is crucial for restoring perfusion and improving outcomes. Achieving optimal flow and providing postprocedural care significantly impact patient prognosis. Rapid diagnosis and intervention are critical in LMCA occlusion with CS. A multidisciplinary approach incorporating advanced circulatory support and timely revascularization are the keys in improving patient outcomes. Comprehensive postprocedural care is essential for ensuring successful recovery and survival.
format Article
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institution Kabale University
issn 2321-449X
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language English
publishDate 2024-12-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Heart India
spelling doaj-art-bad19c860d214100ac743aea76396ee62025-01-08T12:24:35ZengWolters Kluwer Medknow PublicationsHeart India2321-449X2321-66382024-12-0112317717910.4103/heartindia.heartindia_42_24Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shockLagaputi Rama RaoSilpa Chowdari NallapaneniNaga Sri Haritha ParvathaneniAkif Ahamad BaigBikash SahuTotal occlusion of the left main coronary artery (LMCA) is a rare but highly lethal event in acute coronary syndrome. It can lead to extensive myocardial infarction and hemodynamic instability. Despite advancements in percutaneous coronary intervention (PCI), mortality remains high. A 35-year-old male presented with chest pain, dyspnea, and hemodynamic instability. Diagnostic workup revealed LMCA thrombotic occlusion with extensive myocardial involvement and cardiogenic shock (CS). Prompt intervention, including thrombus aspiration, angioplasty, and hemodynamic support with intra-aortic balloon pump and venoarterial extracorporeal membrane oxygenation, was initiated. The patient’s condition gradually improved with comprehensive management, including pharmacotherapy and intensive care support. LMCA occlusion presents challenges due to its extensive myocardial distribution and high mortality rates, particularly when complicated by CS. PCI combined with circulatory support is crucial for restoring perfusion and improving outcomes. Achieving optimal flow and providing postprocedural care significantly impact patient prognosis. Rapid diagnosis and intervention are critical in LMCA occlusion with CS. A multidisciplinary approach incorporating advanced circulatory support and timely revascularization are the keys in improving patient outcomes. Comprehensive postprocedural care is essential for ensuring successful recovery and survival.https://journals.lww.com/10.4103/heartindia.heartindia_42_24cardiogenic shockextracorporeal membrane oxygenationintra-aortic balloon pumpleft main coronary artery
spellingShingle Lagaputi Rama Rao
Silpa Chowdari Nallapaneni
Naga Sri Haritha Parvathaneni
Akif Ahamad Baig
Bikash Sahu
Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
Heart India
cardiogenic shock
extracorporeal membrane oxygenation
intra-aortic balloon pump
left main coronary artery
title Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
title_full Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
title_fullStr Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
title_full_unstemmed Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
title_short Survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
title_sort survival of a young male patient with catastrophic acute left main coronary artery occlusion and cardiogenic shock
topic cardiogenic shock
extracorporeal membrane oxygenation
intra-aortic balloon pump
left main coronary artery
url https://journals.lww.com/10.4103/heartindia.heartindia_42_24
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AT nagasriharithaparvathaneni survivalofayoungmalepatientwithcatastrophicacuteleftmaincoronaryarteryocclusionandcardiogenicshock
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