Acute coronary syndrome in a young patient with ECG presentation of acute inferior myocardial infarction and acute thrombosis of left main stem coronary artery

Introduction. The left main stem coronary artery (MSCA) thrombosis is a rare, but potentially lethal manifestation of the acute syndrome. standard approach in treating such patients primary percutaneous intervention or bypass graft surgery. In some cases, depending on morphological appearance thrombus, findings and flow rates assessed angiography, clinical conditions, cardiologist?s experiences, another method treatment may be conservative using antithrombotic therapy. Case report. A 37 year-old male was admitted to emergency room with symptoms an myocardial infarction ST-elevation diaphragmal localization. Using angiography we have visualized thrombus at ostial proximal part MSCA, no complete obstruction blood flow. Initially, dual therapy (ticagrelor acetylsalycilic acid) applied, further procedure , it decided introduce glycoprotein (GP) IIb/IIIa platelet receptor inhibitor (tirofiban) as intracoronary bolus (0.3 ?g/kg) later continuous infusion (0.1 ?g /kg/min). Four days later, control intravascular echocardiography were performed, continue therapy, without pPCI procedure. patient discharged good condition signs illness eighth day after hospital admission for home recovery, planned frequent follow-ups future. Conclusion. case non-obstructive thrombotic masses significant atherosclerotic stenotic lesions, modality use aggressive considered.