Mural thrombus in an ectatic right coronary artery caused acute myocardial infarction at downstream coronary artery

Related Experiment Video

Updated: Aug 18, 2026

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

Kazushi Urasawa1, Naoki Inoue, Takashi Yokota

  • 1Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.

International Heart Journal
|May 7, 2005
PubMed

Insights

Coronary ectasia, a condition causing artery widening, led to a large blood clot and acute myocardial infarction in a 72-year-old woman. Prompt intervention successfully removed the thrombus, highlighting ectasia as a key factor in this cardiac event.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Acute myocardial infarction (AMI) necessitates rapid diagnosis and intervention.
  • Coronary artery anomalies can predispose individuals to thrombotic events.
  • Thrombus aspiration is a critical technique in managing acute coronary syndromes.

Observation:

  • A 72-year-old female presented with sudden onset chest pain.
  • Emergency coronary angiography identified thrombotic occlusion of the distal right coronary artery.
  • Intravascular ultrasound (IVUS) revealed moderate ectatic changes and minimal atherosclerosis in the proximal right coronary artery.

Findings:

  • A large, cylindrical thrombus was successfully retrieved via aspiration catheterization.
  • IVUS imaging demonstrated a retained mural thrombus with an abrupt termination within the ectatic segment.
  • The findings strongly suggest coronary ectasia as the primary etiology for thrombus formation and subsequent AMI.

Implications:

  • Coronary ectasia should be considered in the differential diagnosis of acute myocardial infarction, particularly in the absence of significant atherosclerosis.
  • Understanding the role of ectasia in thrombus formation can guide therapeutic strategies and improve patient outcomes.
  • This case underscores the importance of advanced imaging modalities like IVUS in elucidating complex coronary pathologies.

More Related Videos

Myocardial Infarction and Functional Outcome Assessment in Pigs12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Circulation01:21

Coronary Circulation

The heart, an organ critical to survival, gets nourishment not from the blood it pumps but from a separate circulation system known as coronary circulation. This is the shortest circulation in the body and is responsible for supplying the heart with the nutrients it needs to function effectively.
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.