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Coronary artery embolism with special reference to invasive procedures as the source
C Yutani1, M Imakita, H Ueda-Ishibashi
1Department of Pathology, National Cardiovascular Center, Suita, Japan.
Summary
Coronary artery embolism, often linked to invasive cardiovascular procedures, is more common than previously believed. This condition, particularly atheromatous emboli, can lead to myocardial infarction and death, requiring clinical vigilance.
Area of Science:
- Cardiology
- Pathology
Background:
- Coronary artery embolism (CAE) has been sporadically reported following invasive cardiovascular procedures since 1978.
- The incidence of CAE in relation to the increased application of these procedures remains unclear.
Purpose of the Study:
- To investigate the incidence and causes of coronary artery embolism.
- To determine if CAE has increased with the wider use of invasive cardiac interventions.
Main Methods:
- Retrospective review of autopsy cases with suspected acute myocardial infarction at the National Cardiovascular Center from 1977 to 1990.
- Analysis of 28 confirmed cases of coronary artery emboli.
Main Results:
- Eighteen cases (10% of myocardial infarction autopsies) confirmed coronary artery emboli.
- Invasive procedures were the cause in 14 patients (50%), including 8 with atheromatous emboli.
- Half of the resulting myocardial infarcts were hemorrhagic; 11 patients died directly from the embolism.
Conclusions:
- Coronary artery embolism is not as rare as previously thought and may be increasing with advancements in invasive cardiovascular procedures.
- Clinicians in cardiovascular fields must maintain awareness of CAE as a potential complication.