[Myocardial infarction due to acute right coronary thrombosis. Treatment with in situ fibrinolysis, absence of angiographic residual stenosis].

The case of a 44 year old patient with inaugural postero-diaphragmatic myocardial infarction is reported. Coronary angiography performed at the 3 rd hour showed total occlusion of the right coronary artery at the level of its second segment. A streptokinase perfusion through a Judkins' catheter positioned in the ostium of the right coronary artery using Rentrop's technique, resulted in recanalisation of the vessel at the 45 th minute. Control coronary angiography on the 10 th day showed an angiographically normal right coronary circulation. The clinical course was complicated by a recurrence on the 12 th day with a new occlusion at the same level. This observation confirms: - the reality of acute coronary thrombosis as a mechanism of myocardial infarction in the absence of significant underlying atherosclerotic stenosis. - the value of early fibrinolytic therapy in situ for limitation of the infarcted myocardial tissues.