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Spontaneously Recanalised Coronary Thrombus in the Left Anterior Descending Artery Presenting as Ventricular

Jie Man Low1, Noah Kimit1, Rizwan Rashid2

  • 1School of Medical Sciences, University of Manchester, Manchester, UK.

Heart International
|October 24, 2022
PubMed

Insights

Spontaneously recanalized coronary thrombus (SRCT) is a rare finding in coronary angiography, often presenting as angina. This case highlights SRCT in the left anterior descending artery, leading to ventricular tachycardia and an old anterior infarct.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Biology

Background:

  • Spontaneously recanalized coronary thrombus (SRCT), also known as honeycomb, lotus root, or Swiss-cheese lesion, is an increasingly recognized finding.
  • It is believed to result from the partial resorption of an initially occlusive thrombus.
  • Common presentations include angina or exertional dyspnea.

Purpose of the Study:

  • To describe a unique case of SRCT presenting as ventricular tachycardia.
  • To illustrate the diagnostic utility of optical coherence tomography (OCT) in SRCT.
  • To discuss management strategies for SRCT.

Main Methods:

  • Coronary angiography was performed to identify SRCT in the left anterior descending artery.
  • Echocardiography and left ventricular (LV) angiography were used to assess LV function and structure.
  • Optical coherence tomography (OCT) was employed for detailed lesion characterization.

Main Results:

  • A 69-year-old patient presented with ventricular tachycardia.
  • Coronary angiography revealed SRCT in the left anterior descending artery.
  • LV angiography demonstrated an akinetic, aneurysmal, thin-walled LV apex, indicative of an old anterior myocardial infarction.

Conclusions:

  • SRCT can present with atypical symptoms such as ventricular tachycardia.
  • OCT is a valuable tool for diagnosing and characterizing SRCT.
  • Management options for SRCT require careful consideration based on clinical presentation and imaging findings.

Keywords:
Spontaneously recanalized coronary thrombushoneycomb lesionlotus root lesionoptical coherence tomographyventricular tachycardia

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