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Coronary Embolism: A Systematic Review

Matthew J Lacey1, Sajjad Raza2, Hasan Rehman3

  • 1Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|June 11, 2019
PubMed

Insights

Coronary embolism, a rare cause of heart attack, often mimics other conditions. Early diagnosis and intervention, like thrombectomy, are crucial for improving patient outcomes and reducing mortality.

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.
Abstract

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