Concurrent Coronary Thromboembolism and Pulmonary Thromboembolism without Right-to-Left Shunt.
- Author:
Min Young LEE
1
;
Duck Hyoung YOON
;
Chan Woo LEE
;
Kyu Tae PARK
;
Myeong Shin RYU
;
Hyun Hee CHOI
;
Kyung Soon HONG
Author Information
1. Division of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. ducks72@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Embolism;
Pulmonary embolism;
Coronary aneurysm;
Myocardial infarction
- MeSH:
Aged;
Aneurysm;
Arteries;
Chest Pain;
Constriction, Pathologic;
Coronary Aneurysm;
Coronary Angiography;
Coronary Vessels;
Dihydroergotamine;
Dyspnea;
Echocardiography;
Electrocardiography;
Embolism;
Emergencies;
Female;
Humans;
Myocardial Infarction;
Myocardial Reperfusion;
Pulmonary Embolism;
Tachypnea;
Thorax;
Thromboembolism;
Thrombosis;
Valsalva Maneuver
- From:Korean Journal of Medicine
2011;81(4):496-501
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 65-year-old woman was referred for management of chest pain and ST segment elevation on electrocardiography. Emergency coronary angiography revealed a well demarcated thrombus that near totally occluded the mid portion of the left anterior descending artery, with a Thrombolysis In Myocardial Infarction (TIMI) flow grade 1, and a fusiform aneurysm on the left main coronary artery. No significant stenosis was observed after aspiration of the thrombus; however, complete coronary reperfusion by urgent aspiration did not improve her dyspnea and tachypnea. Echocardiography revealed a D-shaped left ventricle; thus, we performed a chest computed tomography scan and diagnosed a pulmonary embolism. The patient's coagulation studies were normal. She was prescribed chronic anticoagulation, and we carried out transthoracic echocardiography using second harmonic imaging with agitated saline. Second harmonic imaging with the Valsalva maneuver revealed no right-to-left shunt. We report here a case of concurrent coronary embolism and pulmonary embolism without right-to-left shunt.
