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[Coronary artery embolism from ruptured plaque in the left main trunks with difficulty in detection of culprit

Takatomi Fujimoto1, Eiji Takase, Shinya Fukuhara

  • 1Division of Cardiology, Saiseikai-Suita Hospital, Osaka. takatomi@maia.eonet.ne.jp

Journal of Cardiology
|April 2, 2005
PubMed

Insights

Coronary thromboembolism, a rare cause of heart attack, was diagnosed using intravascular ultrasonography. This imaging technique helped identify a ruptured plaque, leading to successful treatment and recovery.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Imaging

Background:

  • Acute myocardial infarction (AMI) necessitates prompt diagnosis and treatment.
  • Coronary thromboembolism is an uncommon but serious cause of AMI.
  • Identifying the embolic source or culprit lesion in thromboembolic AMI can be challenging.

Observation:

  • A 60-year-old male presented with anterior acute myocardial infarction.
  • Coronary angiography showed stenosis and filling defects but was inconclusive for the embolic source.
  • Intravascular ultrasonography revealed a ruptured plaque with lipid pooling in segment 5.

Findings:

  • The ruptured plaque in segment 5 was identified as the culprit lesion.
  • Successful stent implantation in segment 5 resolved the issue.
  • The patient experienced an excellent clinical outcome post-intervention.

Implications:

  • Intravascular ultrasonography is a valuable tool for diagnosing rare cases of coronary thromboembolism.
  • Early detection of ruptured plaques can improve patient outcomes in acute myocardial infarction.
  • This case highlights the importance of advanced imaging in complex coronary artery disease scenarios.

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