A STEMI Complicated by Cardiogenic Shock due to Simultaneous Acute Thrombosis of Two Coronary Vessels in the ‘Deadly Double Infarct Syndrome’: A Case Report and Discussion of Literature

Introduction: ST-segment elevation myocardial infarction (STEMI) is a leading cause of death worldwide, commonly caused by acute thrombosis over atherosclerotic plaques. This report presents a rare case of simultaneous acute thrombosis in two coronary arteries, leading to STEMI associated with cardiogenic shock. Case Presentation: A 58-year-old male with a history of hypertension, type II diabetes, and heavy smoking presented with two days of chest pain and was found in cardiogenic shock upon arrival. His ECG showed ST-segment elevation in AVR and ischemia, while echocardiography revealed severe left ventricular dysfunction (EF 20%). Emergency coronary angiography identified significant occlusions in both the proximal circumflex branch and left anterior descending artery (LAD). Despite successful thrombus aspiration and stenting, the patient developed serious complications, including infections, pleural effusions, and paralytic ileus. After nearly two months in the intensive coronary care unit with persistent heart failure, he was referred for evaluation of left ventricular assist device implantation. Conclusion: This case highlights the challenges of managing cardiogenic shock in simultaneous thrombotic events in STEMI, underscoring the need for rapid intervention and tailored management strategies in critically ill patients. Further research is necessary to optimize revascularization approaches and improve outcomes in similar cases.