In most cases of thrombosis involving a coronary artery a single artery is involved. Rarely multiple arteries may be thrombosed.
Factors associated with thrombosis of multiple coronary arteries:
(1) severe multi-vessel arteriosclerosis
(2) multiple plaque ruptures
(3) hypercoagulable state (heparin induced thrombocytopenia, essential thrombasthenia, autoimmune ITP, etc)
(4) cocaine or amphetamine abuse
(5) cardiogenic shock following occlusion of one artery
(6) coronary vasculitis
The patient may present with ST-segment elevation but the pattern may not match a single arterial distribution.
Angiography should demonstrate the nature and extent of thrombosis.
