Coronary Embolism: A Systematic Review.

Area of Science:

• Cardiology
• Vascular Medicine
• Medical Diagnostics

Background:

• Coronary embolism is a rare but life-threatening condition, primarily affecting patients with valvular heart disease and atrial fibrillation.
• Current diagnostic and treatment guidelines for coronary embolism lack consensus, leading to individualized physician management.
• This review aims to enhance understanding and identify therapeutic options for coronary embolism.

Purpose of the Study:

• To systematically review existing literature on coronary embolism.
• To identify common etiologies and clinical presentations of coronary embolism.
• To explore available invasive and non-invasive treatment strategies for coronary embolism.

Main Methods:

• A systematic review of 147 documented cases of coronary embolism from case reports and case series.
• Analysis of patient demographics, common causes, diagnostic methods, and treatment interventions.
• Evaluation of patient outcomes, including myocardial dysfunction and mortality rates.

Main Results:

• The most frequent causes identified were infective endocarditis (22.4%), atrial fibrillation (17.0%), and prosthetic heart valve thrombosis (16.3%).
• Coronary embolism presentations were often mistaken for acute coronary syndrome (ACS) from atherosclerosis, necessitating high suspicion and angiography for diagnosis.
• Over 80% of patients experienced myocardial dysfunction post-embolism, with reported good outcomes in 68.7% and a mortality rate of 12.9%.

Conclusions:

• Coronary embolism is an under-recognized cause of myocardial infarction with significant morbidity and mortality.
• Early diagnosis and etiology-specific interventions are vital for improving patient outcomes.
• Thrombectomy is a potential intervention for rapid restoration of coronary blood flow.