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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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[Recurrent acute myocardial infarction as a thromboembolic complication of atrial fibrillation]

János Tomcsányi1, Katalin Takó1, Balázs Sármán1

  • 1Kardiológia, Budai Irgalmasrendi Kórház Budapest, Árpád fejedelem u. 7., 1023.

Orvosi Hetilap
|January 24, 2016
PubMed

Insights

Recurrent myocardial infarction due to atrial fibrillation is rare. This case report details a patient experiencing a second heart attack caused by blood clots originating from atrial fibrillation, highlighting a critical complication.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Clinical Case Reports

Background:

  • Atrial fibrillation is a common arrhythmia associated with thromboembolic events.
  • Coronary artery thromboembolism leading to myocardial infarction is a recognized but infrequent complication of atrial fibrillation.
  • Previous myocardial infarction (MI) increases the risk of future cardiovascular events.

Observation:

  • A 55-year-old male with a history of MI and paroxysmal atrial fibrillation presented with recurrent chest pain.
  • Clinical presentation included ST-segment elevation, indicative of acute myocardial infarction.
  • Diagnostic workup revealed new thrombus formation in the circumflex coronary artery.

Findings:

  • Coronary angiography confirmed the presence of a thrombus in the circumflex artery.
  • Transesophageal echocardiography identified a thrombus in the left atrial appendage.
  • This represents the first reported case of recurrent myocardial infarction directly attributed to atrial fibrillation.

Implications:

  • This case underscores the significant risk of recurrent thromboembolic events in patients with atrial fibrillation.
  • It highlights the importance of comprehensive anticoagulation strategies in managing atrial fibrillation patients with a history of MI.
  • Further research may be warranted to explore the mechanisms and optimal management of recurrent MI in this patient population.

Keywords:
acute myocardial infarctionakut myocardialis infarctusatrial fibrillationcoronariaembolisatiocoronary artery embolismpitvarfibrillációthromboemboliathromboembolism

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