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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

Myocardial infarction with huge mural thrombus due to spontaneous coronary artery dissection detected by

Sang Min Park, Kwang Kon Koh, Jeong Ho Kim

    International Journal of Cardiology
    |August 11, 2007
    PubMed

    Insights

    A young man experienced chest discomfort and ECG abnormalities due to spontaneous coronary artery dissection (SCAD). Advanced imaging accurately diagnosed SCAD with left ventricular thrombus, avoiding myocardial infarction.

    Area of Science:

    • Cardiology
    • Radiology
    • Vascular Medicine

    Background:

    • A 28-year-old male presented with unexplained ECG abnormalities and chest discomfort.
    • Initial evaluation was prompted by symptoms suggestive of cardiac compromise in a patient with no prior cardiovascular history.

    Observation:

    • Echocardiogram revealed regional wall motion abnormalities, left ventricular aneurysm, and a large mural thrombus.
    • Coronary angiography identified a dissection in the mid-left anterior descending (LAD) coronary artery.
    • ECG-gated 64-multidetector computed tomography (MDCT) confirmed the LAD dissection.

    Findings:

    • The case highlights spontaneous coronary artery dissection (SCAD) as a cause of cardiac symptoms in young adults.
    • A significant finding was the presence of a large left ventricular mural thrombus associated with SCAD.
    • Crucially, despite the dissection and thrombus, there was no evidence of acute myocardial infarction.

    Implications:

    • MDCT provides an accurate, non-invasive method for diagnosing SCAD and associated complications.
    • This case underscores the importance of considering SCAD in young individuals presenting with cardiac symptoms.
    • Early and accurate diagnosis is critical for managing SCAD and preventing adverse cardiac events like myocardial infarction.

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