A young male following road traffic accident (RTA) with head injury and parietal bleed was diagnosed with STEMI based on ECG findings which is rare occurrence. Coronary angiography showed thrombotic ostial occlusion of LAD. Successful primary angioplasty using thrombo-aspiration was done, in difficult clinical scenario. The case was challenging in terms of use of anticoagulation and antiplatelet strategy in a rare etiology of acute myocardial infarction following road traffic accident.
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