Coronary artery disease: not always the case for ST-elevation myocardial infarction
Anna Dagre1, Nikos Kouris, Christopher Olympios
1Cardiac Catheterization Laboratory, Thriassio General Hospital of Elefsis, Athens, Greece. annadagre@hotmail.com
Insights
This case study highlights acute myocardial infarction in a woman with a mechanical mitral valve. Prompt intervention restored blood flow, but a valve thrombus necessitated replacement, underscoring the importance of diagnosing embolic causes.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Mechanical mitral valve prostheses are associated with thromboembolic complications.
- Subtherapeutic anticoagulation increases the risk of thrombus formation on prosthetic valves.
- Embolic myocardial infarction is an underdiagnosed condition that requires prompt recognition.
Abstract:
We report a case of an acute ST-T elevation myocardial infarction in a middle-aged female with a mechanical mitral valve prosthesis and subtherapeutic INR levels. We performed a primary coronary intervention, using a thromboaspiration catheter. After blood clot aspiration, a TIMI III flow was restored and no residual lesions remained at the site of the occlusion. A transesophageal echo revealed a movable thrombus over the mechanical mitral valve prosthesis and patient underwent subsequent mitral valve replacement. Embolic myocardial infarction remains underdiagnosed. A high level of suspicion and the quest of the source of embolus are crucial.
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