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Vojnosanitetski pregled
2016, vol. 73, br. 1, str. 73-76
jezik rada: engleski
vrsta rada: prikaz slučaja
doi:10.2298/VSP141103130S

Creative Commons License 4.0
Uspešne primarne perkutane intervencije kod bolesnika sa dva uzastopna infarkta miokarda sa elevacijom ST-segmenta i dvostrukom prednjom descedentnom arterijom (tip IV)
aClinic for Cardiology, Institute of Radiology, Military Medical Academy, Belgrade
bClinic for Emergency and Internal Medicine, Institute of Radiology, Military Medical Academy, Belgrade
cInstitute of Radiology, Military Medical Academy, Belgrade
dClinic for Emergency and Internal Medicine, Institute of Radiology, Military Medical Academy, Belgrade + Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade
eFaculty of Medicine of the Military Medical Academy, University of Defence,

e-adresa: dzuda1977@gmail.com

Sažetak

Uvod. Dvostruka prednja descedentna arterija (PDA) je veoma retka urođena anomalija i može biti otkrivena slučajno tokom primarne perkutane koronarne intervencije (pPKI) što može stvoriti poteškoće u određivanju i lečenju infarktne lezije. Prikaz bolesnika. Prikazali smo muškarca, starog 52 godine, sa infarktom miokarda sa ST-elevacijom (STEMI) donjeg zida, kod koga je tokom pPKI otkrivena dvostruka PDA. Kratka PDA je imala ishodište iz levog glavnog koronarnog stabla, a dugačka PDA iz proksimalnog dela desne koronarne arterije (DKA). Na mestu infarktne lezije u DKA uspešno je implantiran metalni stent i postignuta rezolucija ST-segmenta u EKG-u. Nakon dva sata, bolesnik je vraćen u angiosalu zbog novog STEMI anteroseptalne lokalizacije. Drugi metalni stent implantiran je na mestu nove infarktne lezije, ovog puta u proksimalnom delu kratke PDA. Zaključak. Pravilna interpretacija EKG-a od velike je pomoći u detekciji i lečenju infarktne lezije kod retke anomalne dvostruke PDA.

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