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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

Contrast-enhanced computed tomographic and echocardiographic detection of intra-aortic floating thrombus causing

Tsunenari Soeda1, Satoshi Okayama, Ayako Seno

  • 1First Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan.

Journal of Cardiovascular Computed Tomography
|November 12, 2010
PubMed

Insights

A rare case of acute myocardial infarction (AMI) caused by left main coronary artery (LMCA) occlusion from an intra-aortic thrombus is presented. This unusual thrombus formation led to a fatal outcome despite intervention.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Acute myocardial infarction (AMI) typically results from coronary artery atherosclerosis.
  • Left main coronary artery (LMCA) occlusion is a rare but catastrophic cause of AMI.

Observation:

  • A 51-year-old man presented with symptoms suggestive of AMI.
  • Coronary angiography showed no native coronary lesions.
  • Computed tomography (CT) and echocardiography identified an intra-aortic thrombus near the LMCA ostium.

Findings:

  • The intra-aortic thrombus was determined to be the cause of LMCA occlusion and subsequent AMI.
  • Despite stent implantation to maintain LMCA patency, the patient succumbed to sepsis.
  • Post-mortem examination confirmed the thrombus was attached to an atherosclerotic aortic wall.

Implications:

  • This case highlights an unusual etiology for LMCA occlusion and AMI.
  • Intra-aortic thrombus formation requires consideration in the differential diagnosis of acute coronary syndromes.
  • Atherosclerotic aortic disease can be a substrate for thrombus formation causing coronary occlusion.

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