Simultaneous Plaque Rupture in Two Coronary Arteries Presenting as Acute Coronary Syndrome.

A 45 yrs male presented with angina. ECG showed transient CHB, T wave inversion in V3 to V6 and inferior leads. It was difficult to predict the culprit vessel based on ECG. Coronary angiography showed thrombotic lesions in LAD, LCX and OM which can potentially impact identification of culprit vessel and hence affect the management with primary PCI.