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Microvascular Coronary Artery Embolism Presenting as an OHCA STEMI Call Detected by CMRI

Napohn Chongprasertpon1, Santhosh David1

  • 1Department of Cardiology, Letterkenny University Hospital, Letterkenny, Co. Donegal, Ireland.

European Journal of Case Reports in Internal Medicine
|September 10, 2020
PubMed

Insights

Coronary artery embolism is rare but serious. Cardiac magnetic resonance imaging aided diagnosis in a patient with out-of-hospital cardiac arrest, highlighting its potential role in improving diagnostic criteria for this condition.

Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Coronary artery embolism is an uncommon cause of myocardial infarction.
  • Accurate diagnosis is crucial due to a poor prognosis.

Purpose of the Study:

  • To report a case of coronary artery embolism diagnosed using cardiac magnetic resonance imaging (CMR).
  • To discuss the utility of CMR in diagnosing coronary artery embolism and suggest improvements in diagnostic criteria.

Main Methods:

  • Case report of a patient presenting with out-of-hospital cardiac arrest.
  • Diagnostic coronary angiography.
  • Cardiac magnetic resonance imaging to assess myocardial infarction and microvascular obstruction.

Main Results:

  • Coronary angiography showed patent arteries, not revealing the cause.
  • CMR demonstrated myocardial infarction and focal microvascular obstruction.
  • CMR successfully identified findings consistent with coronary artery embolism.

Conclusions:

  • Coronary artery embolism, though uncommon, requires accurate diagnosis for better patient outcomes.
  • Current diagnostic scoring systems for coronary artery embolism do not incorporate CMR.
  • CMR should be considered for inclusion in diagnostic criteria for coronary artery embolism detection.

Keywords:
Cardiac magnetic resonance imagingST-segment elevation myocardial infarctioncoronary artery embolism

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