Related Experiment Videos
[Multiple coronary embolisms in a woman with risk factors for thromboembolic disease]
Isabel Antorrena Miranda1, Ramón Arroyo Esplieguero, Joaquín Carneado Ruiz
1Servicio de Cardiología. Clínica Puerta de Hierro. Madrid. España. iantorrena@hotmail.com
Insights
A young woman experienced recurrent myocardial infarction (heart attack) due to multiple coronary artery emboli. Oral contraceptives and smoking were identified as potential contributing factors in this rare case.
Area of Science:
- Cardiology
- Internal Medicine
- Vascular Medicine
Background:
- ST-elevation myocardial infarction (STEMI) typically results from acute coronary thrombosis.
- Risk factors for myocardial infarction include smoking and oral contraceptive use, particularly in younger individuals.
Observation:
- A 33-year-old woman, a smoker using oral contraceptives, presented with anterior STEMI.
- Recurrent chest pain occurred post-thrombolytic therapy, with diagnosis of inferior STEMI.
- Coronary angiography revealed multiple embolic occlusions in coronary branches.
Findings:
- The patient's presentation suggests a non-atherosclerotic cause of myocardial infarction, likely embolic.
- Oral contraceptives and smoking may have contributed to a hypercoagulable state, predisposing to embolic events.
Implications:
- This case highlights the importance of considering embolic causes of myocardial infarction in young women with specific risk factors.
- Further investigation into thrombophilia and the role of oral contraceptives in arterial embolism is warranted.
- Management strategies may need to be tailored based on the underlying pathophysiology of myocardial infarction.
Abstract:
We report the case of a 33-years-old woman, smoker and taking oral contraceptives, who presented to the emergency room with an anterior ST-elevation myocardial infarction. Thrombolytic treatment was initiated and a few minutes after, chest pain returned and an inferior ST-segment-elevation infarction was diagnosed at that moment. Catheterization revealed multiple embolic occlusion of coronary branches. We discuss tests performed and pathophysiology of myocardial infarction in this patient.