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[Acute stent thrombosis and reverse transient left ventricular dilatation after performing a single-photon emission

B Miranda1, M N Pizzi1, S Aguadé-Bruix2

  • 1Servicio de Cardiología, Hospital Universitari Vall d́Hebron, Barcelona, España.

Revista Espanola De Medicina Nuclear E Imagen Molecular
|August 18, 2014
PubMed

Insights

A patient developed stent thrombosis after exercise, leading to acute ischemia and reduced ejection fraction. This highlights the risk of thrombosis in recently implanted coronary stents, especially with physical exertion.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Cardiovascular Imaging

Background:

  • Coronary artery disease management often involves stent implantation.
  • Assessing myocardial perfusion is crucial for diagnosing and managing ischemic heart disease.
  • Recently implanted stents may be vulnerable to thrombotic events.

Observation:

  • A 63-year-old male presented with vegetative symptoms three months post-stent implantation.
  • During myocardial perfusion imaging, the patient experienced chest pain and ST elevation.
  • Urgent cardiac catheterization revealed stent thrombosis.

Findings:

  • Rest gated-SPECT myocardial perfusion imaging demonstrated significant anterior and apical perfusion defects.
  • These defects were more severe than those observed during stress imaging.
  • Acute ischemia resulted in striking left ventricular dilatation and a reduced ejection fraction.

Implications:

  • Intense exercise can transiently activate coagulation and alter hemodynamics.
  • This may precipitate thrombosis in non-endothelialized coronary stents.
  • The findings underscore the importance of careful patient monitoring after stent placement, particularly concerning physical activity.

Keywords:
Acute stent thrombosisCardiopatía isquémicaDilatación transitoria ventricular inversaIschemic heart diseaseMyocardial perfusionPerfusión miocárdicaSingle-photon emission computed tomographyTomografía computarizada de emisión monofotónicaTransient reverse ventricular dilationTrombosis aguda stent

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