AI Article Synopsis
- Coronary embolism (CE) is a rare cause of acute ST-elevation myocardial infarction (STEMI), often related to conditions like atrial fibrillation and left ventricular thrombus.
- A case of a 60-year-old woman with anterior STEMI due to paroxysmal atrial fibrillation and a history of stroke illustrates how CE can manifest in clinical practice.
- Major diagnostic criteria for CE include non-atherosclerotic coronary vessels and evidence of intra-cardiac thrombus, while minor criteria consider aspects like history of atrial fibrillation and other risk factors.
Article Abstract
Introduction: Coronary embolism (CE) is a rare cause of acute ST-elevation myocardial infarction (STEMI). Atrial fibrillation (AF), left ventricular thrombus, septic emboli from infective endocarditis, myxoma, and paradoxical embolism can induce emboli in coronary arteries.
Case Presentation: Here we present a case of anterior wall STEMI secondary to paroxysmal AF in a 60-years-old female with a previous history of right-sided ischemic stroke.
Discussion: The major criteria for diagnosis of coronary embolism include (1) non-atherosclerotic wall of coronary vessels under angiography; (2) concomitant involvement of multiple sites; (3) histological proof of venous thrombus; (4) imaging by echocardiography/CT/MRI showing intra-cardiac thrombus. The minor criteria include (1) <25% stenosis of other vessels supplying to infarct-free myocardium; (2) atrial fibrillation history; (3) risk factors like (prosthetic valve, bacterial endocarditis, patent foramen ovale, atrial septal defect, dilated cardiomyopathy).
Conclusion: Our case highlights the importance of cardiac embolus as a diagnosis in a patient with a history of stroke secondary to atrial fibrillation as a cause of acute STEMI and its management.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577526 | PMC |
| http://dx.doi.org/10.1016/j.amsu.2022.104602 | DOI Listing |
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