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Acute ST-segment elevation myocardial infarction due to a huge floating thrombus mimicking a myxoma in the left

Min Su Kim1, Jae-Hyeong Park, Shin Kwang Kang

  • 1Division of Cardiology, Department of Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|September 8, 2009
PubMed

Insights

Acute ST-segment elevation myocardial infarction (STEMI) can be caused by coronary artery obstruction. This case highlights a rare cause: a large left atrial thrombus, which can mimic other cardiac conditions.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Acute ST-segment elevation myocardial infarction (STEMI) is a critical condition resulting from complete coronary artery blood flow interruption.
  • Atherosclerotic plaque rupture is the most frequent cause of acute coronary artery occlusion.
  • Embolism from various sources represents an alternative, though less common, etiology for abrupt coronary obstruction.

Observation:

  • The authors present a unique case of STEMI.
  • The infarction was attributed to a massive thrombus originating in the left atrium.
  • This left atrial thrombus presented clinically and diagnostically as a cardiac myxoma.

Findings:

  • The study identifies a large left atrial thrombus as the cause of acute ST-segment elevation myocardial infarction.
  • The thrombus successfully mimicked the presentation of a cardiac myxoma, posing a diagnostic challenge.
  • This finding underscores the importance of considering thrombus embolism in the differential diagnosis of coronary obstruction.

Implications:

  • This case broadens the understanding of STEMI etiologies beyond typical atherosclerotic causes.
  • It emphasizes the need for comprehensive diagnostic evaluation to differentiate left atrial thrombus from cardiac tumors.
  • Early and accurate diagnosis is crucial for appropriate management and improved patient outcomes in STEMI cases with unusual causes.

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