Trombose simultanea em duas artérias coronárias epicárdicas durante infarto agudo do miocárdio

young patient with a history of smoking, hypertension and use of illicit drugs (cannabis, cocaine and crack) was admitted with precordial pain after physical exercise within the previous two hours. electrocardiogram demonstrated st segment elevation in leads v1 to v4 and the patient was referred to cardiac catheterization, which showed total occlusion of the left anterior descending artery and a large amount of thrombi in the right coronary artery. the patient was treated with direct stenting in the left anterior descending artery and triple antiplatelet therapy with aspirin, clopidogrel and abciximab in combination with non-fractioned heparin for 24 hours. angiography and intravascular ultrasound assessment after 48 hours demonstrated a complete resolution of thrombi in both coronary arteries.