Intermittent mechanical prosthesis blockage mimicking acute coronary syndrome

Valve blockage is one of the most serious complications of a mechanical prosthesis. Its annual incidence ranges from < 0.5% to 4.5% per patient/year. The diagnosis is not always done in time, as the clinical presentation is highly variable. In order to better understand the spectrum of clinical presentation of this complication, this paper presents the clinical case of a 64 year-old woman, whose personal medical history included aortic valve replacement with a monoleaflet Medtronic Hall® (Medtronic Inc, Minneapolis, MN) 21 mm, transferred from a peripheral hospital with the diagnosis of acute coronary syndrome of the anterolateral wall, with ST-segment depression and intermittent cardiogenic shock. The authors reviewed also the blockage mechanisms and its implications on the diagnosis and management of this potentially lethal condition.