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

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Published on: June 11, 2019

Extensive coronary thrombus causing full thickness myocardial infarction

Nicholas Curzen1, Robert Hatrick, Charles Peebles

  • 1Wessex Cardiac Unit, Southampton University Hospital, Southampton, UK. nick.curzen@suht.swest.nhs.uk

Acute Cardiac Care
|September 14, 2007
PubMed

Insights

This case study highlights a young male with ST-elevation myocardial infarction. Cardiac MRI confirmed infarction, indicating no further intervention was needed, with the patient recovering well.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • ST-elevation myocardial infarction (STEMI) requires prompt reperfusion therapy.
  • Thrombolytic therapy failure necessitates rescue angioplasty.
  • Extensive thrombus burden can complicate percutaneous coronary intervention.

Observation:

  • A young male presented with STEMI 22 hours after symptom onset.
  • Rescue angioplasty revealed extensive thrombus in the left anterior descending artery.
  • Symptoms resolved, and thrombectomy was deferred due to risks.

Findings:

  • Cardiac MRI with delayed gadolinium hyper-enhancement confirmed full-thickness infarction in the LAD territory.
  • No further intervention was indicated based on imaging findings.
  • The patient remained asymptomatic with minimal heart failure symptoms at one-year follow-up.

Implications:

  • Cardiac MRI is crucial for assessing myocardial viability and guiding intervention in complex STEMI cases.
  • Conservative management guided by imaging can be effective despite significant thrombus burden.
  • Successful management of STEMI with extensive thrombus can lead to favorable long-term outcomes.

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