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Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model
Published on: November 4, 2021
Left main coronary embolism
Victor M Mejia1, Y Joseph Woo, Howard C Herrmann
1Cardiology Department and Cardiothoracic Surgery Department, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Insights
A rare case of acute myocardial infarction (MI) caused by a left main artery embolus in a patient with prior mitral valve repair is presented. This uncommon cause highlights the importance of considering diverse etiologies in cardiogenic shock.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Mitral regurgitation is a significant valvular heart disease.
- Mitral valve repair is a common surgical intervention.
- Cardiogenic shock is a life-threatening condition requiring prompt diagnosis.
Observation:
- A 58-year-old female with a history of mitral regurgitation presented with cardiogenic shock post-mitral valve repair.
- She subsequently developed an anterior ST-elevation myocardial infarction.
- Pericardial effusion was also noted during her readmission.
Findings:
- Coronary angiography identified an embolus occluding the left main coronary artery.
- Rheolytic thrombectomy was successfully employed to treat the arterial embolus.
- This case illustrates an unusual etiology for acute myocardial infarction.
Implications:
- Embolic events in the left main artery are a rare cause of ST-elevation myocardial infarction.
- This case underscores the need for comprehensive etiological investigation in patients with cardiogenic shock and myocardial infarction.
- Advanced interventional techniques like rheolytic thrombectomy can be effective in managing complex embolic occlusions.
Abstract:
This is a case of a 58-year-old female with a history of mitral regurgitation who had undergone mitral valve repair and was readmitted in cardiogenic shock with pericardial effusion, and then developed an anterior ST-elevation myocardial infarction. Coronary angiography revealed an embolus in the left main artery which was treated with rheolytic thrombectomy. This represents an uncommon cause of acute myocardial infarction.
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