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Updated: Jul 13, 2026
06:29
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
A Left Main Coronary Artery Thrombus Presenting as a Non St Elevation MI
U Ezema1, D Daberkow1, T Delord1
1Department of Medicine, Leonard J. Chabert Medical Center, Houma, LA.
Summary
Left main coronary artery thrombosis (LMCAT) is a rare, life-threatening condition presenting as myocardial infarction. This case highlights conservative management for LMCAT, emphasizing watchful waiting for thrombus resorption.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Left main coronary artery (LMCA) thrombus with acute myocardial infarction is rare and carries a high mortality rate.
- This case presents a rare instance of LMCA thrombus manifesting as non-ST elevation myocardial infarction (NSTEMI).
Purpose of the Study:
- To report a case of LMCA thrombus presenting as NSTEMI.
- To discuss the diagnostic and management challenges of this rare condition.
Main Methods:
- A 45-year-old woman with chest pain underwent cardiac workup, including troponin levels and EKG.
- Coronary angiography revealed a large thrombus in the LMCA extending into the aorta.
- Echocardiography identified a patent foramen ovale (PFO) and regional wall motion abnormalities.
Main Results:
- The patient presented with symptoms consistent with NSTEMI and had elevated troponin levels.
- Angiography confirmed a significant thrombus burden in the LMCA and distal LAD stenosis.
- Conservative management with medical optimization and watchful waiting was recommended.
Conclusions:
- LMCA thrombosis is a rare, life-threatening condition with varied presentations, including NSTEMI.
- Potential causes include plaque rupture, hypercoagulable states, and embolization.
- Standardized therapeutic approaches are lacking due to the rarity of reported cases.
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