Acute myocardial infarction from simultaneous total occlusion of the left circumflex and right coronary artery. A case report.

We report a case of an 82-year-old female presenting with symptoms of chest pain, nausea, dizziness and electrocardiographic evidence of ST segment elevation in inferior and ST depression in anterior leads. Emergent coronary angiogram showed totally occluded mid left circumflex and a totally occluded distal right coronary artery, there was no response to intracoronary nitroglycerin before intervention. Both arteries were successfully ballooned and stented. Multiple cases of simultaneous coronary occlusion has been reported and different mechanisms has been postulated but exact mechanism is still not well understood.