A Case of Acute Myocardial Infarction Caused by Distal Embolization of a Left Main Coronary Artery Thrombus.
- Author:
Kyung Ryun BAE
1
;
Young Soo LEE
;
Byong Kyu KIM
;
Geun Jin HA
;
So Yeon KIM
;
Ji Young CHOI
;
Kee Sik KIM
Author Information
- Publication Type:Case Report
- Keywords: Embolism; Myocardial infarction
- MeSH: Angioplasty, Balloon; Chest Pain; Coronary Angiography; Coronary Vessels; Electrocardiography; Embolism; Follow-Up Studies; Glycoproteins; Humans; Male; Middle Aged; Myocardial Infarction; Thrombosis
- From:Korean Circulation Journal 2010;40(1):46-49
- CountryRepublic of Korea
- Language:English
- Abstract: Coronary embolism is an uncommon cause of myocardial infarction. A 48-year-old male presented with typical chest pain of an MI. There was no definite ST segment change on electrocardiogram (ECG) and no elevation of myocardial enzymes. Coronary angiography (CAG) revealed occlusion of the distal left anterior descending coronary artery (dLAD), the distal left circumflex coronary artery (dLCX), the diagonal branch (D) and the obtuse marginal branch (OM), with a large filling defect in the left main coronary artery (LMA) that caused the myocardial infarction. We considered the possibility that coronary embolization was caused by the migration of a thrombus in the LMA during CAG. We did balloon angioplasty in the dLAD, dLCX, OM and D and treated the patient with glycoprotein IIb/IIIa receptor antagonist. However, thrombi remained in the dLAD, OM, and dLCX. After 3 days of anti-thrombotic treatment, follow-up CAG revealed only slight resolution of thrombi in the LAD. After triple antiplatelet agent medication for 1 year, a follow-up CAG showed a resolution of the thrombi in all coronary arteries.
