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Published on: April 25, 2014
Coronary artery ectasia presenting with thrombus embolization and acute myocardial infarction: A case report
Yongle Li1, Chengcheng Wu, Wennan Liu
1Department of Cardiology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China.
Insights
Coronary artery ectasia (CAE) can cause acute myocardial infarction (AMI) due to thrombus formation. Long-term warfarin and antiplatelet therapy effectively restored coronary blood flow in a young patient with CAE-related AMI.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary artery ectasia (CAE) involves abnormal coronary artery dilatation, often linked to slow flow and acute myocardial infarction (AMI) risk, even without occlusion.
- CAE presents a unique challenge in managing myocardial infarction due to potential thrombus burden.
Rationale:
Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. CAE is often associated with the presence of slow coronary flow and may lead to acute myocardial infarction (AMI), even without total occlusion.
Patient Concerns And Diagnosis:
We report a case of a 24-year-old male patient with CAE suffering from AMI.
Interventions:
Percutaneous coronary intervention with aspiration thrombectomy failed to restore adequate blood flow. Heparin and antiplatelet treatment were provided for pharmacological management, but follow-up angiography 15 days later still revealed a poor result. This patient was ultimately treated with antiplatelet therapy in combination with warfarin treatment.
Outcomes:
Follow-up coronary angiography 15 months later showed a restored normal Thrombolysis In Myocardial Infarction grade (TIMI) 3 flow.
Lessons:
CAE-related infarct is often associated with high-burden thrombus formation. Long-term warfarin in combination with antiplatelet therapy may be a good alternative intervention to decrease thrombus burden and enhance blood flow.
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