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Published on: February 28, 2012

Warfarin and herbal products interaction causing prosthetic aortic valve thrombosis presenting as acute myocardial

Cesar E Mendoza1, Alexandre C Ferreira, Eduardo de Marchena

  • 1Division of Cardiology, Jackson Memorial Hospital, University of Miami School of Medicine, Miami, Florida 33136, USA. mendozatrauco@yahoo.com

The Journal of Heart Valve Disease
|February 10, 2004
PubMed

Insights

Prosthetic heart valve thrombosis can cause rare but fatal myocardial infarction (MI) through coronary embolization. Inadequate anticoagulation due to drug-herb interactions is a key risk factor in patients with mechanical heart valves.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Pharmacology

Background:

  • Prosthetic heart valve thrombosis is a serious complication.
  • Myocardial infarction (MI) from coronary artery embolization is a rare but life-threatening consequence.

Observation:

  • A 58-year-old male with a bileaflet mechanical aortic valve replacement presented with acute anterior MI.
  • Physical examination, echocardiography, and cinefluoroscopy revealed valvular dysfunction.
  • Coronary angiography confirmed embolization of the left anterior descending artery.

Findings:

  • Reoperation identified thrombotic encroachment on a prosthetic valve leaflet.
  • Inadequate anticoagulation, likely due to warfarin-herbal product interaction, was identified as the probable cause.

Implications:

  • Highlights the diagnostic and treatment considerations for acute MI in patients with left-sided prosthetic heart valves.
  • Emphasizes the critical importance of maintaining adequate anticoagulation in this patient population.
  • Underscores the potential for drug-herb interactions to compromise anticoagulation therapy.

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