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Left ventricular mural thrombus and dual coronary embolization associated with hyperthyroid cardiomyopathy and atrial

Guohui Liu1, Ping Yang1, Yuquan He2

  • 1Department of Cardiology, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, 130000, China.

BMC Cardiovascular Disorders
|May 21, 2017
PubMed

Insights

Coronary embolism, a rare cause of acute myocardial infarction (AMI), can arise from left ventricular thrombi associated with hyperthyroid cardiomyopathy and atrial fibrillation. This case highlights a fatal instance of multi-site coronary artery embolization.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pathology

Background:

  • Acute myocardial infarction (AMI) is typically caused by coronary thrombosis due to atherosclerotic plaque rupture.
  • Coronary embolism (CE) is an increasingly recognized, albeit rare, cause of AMI.
  • Hyperthyroidism-related cardiomyopathy and atrial fibrillation (AF) can predispose to thrombus formation.

Observation:

  • A 49-year-old female with hyperthyroidism and AF presented with limb symptoms.
  • Echocardiography revealed left ventricular apical mural thrombi and cardiomyopathy.
  • The patient subsequently developed acute myocardial infarction (AMI) with multi-site coronary embolization.

Findings:

  • Coronary angiography confirmed emboli in the left anterior descending artery and a diagonal branch.
  • Despite intervention, the patient experienced ventricular fibrillation and expired.
  • This case represents a fatal instance of dual-vessel coronary embolism linked to hyperthyroid cardiomyopathy and AF.

Implications:

  • Highlights the potential for cardiac thrombi in hyperthyroid cardiomyopathy to cause coronary embolism.
  • Underscores the importance of considering CE in AMI patients with AF and cardiac thrombi.
  • Emphasizes the often-fatal outcome of extensive coronary embolism.
Abstract

Keywords:
Embolizationacute myocardial infarctionatrial fibrillationballoon angioplasty

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