SYMPTOMATIC REINFARCTION OF A PREVIOUSLY SILENT MYOCARDIAL REGION 4 MONTHS AFTER SUCCESSFUL REPERFUSION - A CASE-REPORT

Coronary collateral circulation helps to preserve myocardial perfusion distal to severely stenotic or totally obstructed coronary arteries. The presence or absence of angina pectoris and the state of myocardial function depend on the extent of collateralization and its functional contribution to myocardial blood flow. Clinical and experimental obse rvations have suggested that newly developed collaterals usually remai n even after successful revascularizaton. The authors present a case o f a patient with extensive intercoronary collaterals and hibernating m yocardium after an acute inferior wall myocardial infarction who under went successful percutaneous transluminal coronary angioplasty of a to tally obstructed, dominant right coronary artery and then experienced extensive reinfarction following reocclusion 4 months later. This case demonstrates failure of extensive collaterals to prevent acute myocar dial infarction.