a b s t r a c tThe management of acute coronary syndrome (ACS) and heart failure (HF) in centenarians is specially challenging because these patients suffer from multiple comorbidities, altered anatomy, physiology, and response to medications compared with younger patients. Unfortunately, there are no specific guidelines for this age group. We herein report an experience of treating a woman 101 years of age with ACS and HF, had a complex coronary angiographic procedure, and proved to have coronary artery disease with the involvement of multiple vessels. Due to the very high risk of being treated surgically or by transcatheter coronary interventions, the clinical course became stable with multidisciplinary conservative medical treatment, which resulted in survival and maintenance of quality of life.
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