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Coronary Embolism in Patient with Prosthetic Aortic Valve: Looks Can Be Deceiving
Alfredo Mauriello1,2, Beatrice D'Arco3, Alfonso Desiderio2
1Department of Medical Translational Sciences, Monaldi Hospital, University of Campania "Luigi Vanvitelli", Naples, Italy.
Insights
Coronary embolism, a rare cause of acute coronary syndrome, was identified in a patient with a bioprosthetic aortic valve and atrial fibrillation. Further monitoring was initiated to guide therapy for this challenging case.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Acute coronary syndrome (ACS) necessitates prompt diagnosis and management.
- Coronary embolism is an uncommon etiology of ACS, often presenting diagnostic challenges.
- Bioprosthetic aortic valves and atrial fibrillation are potential risk factors for embolic events.
Observation:
- A 68-year-old female presented with ST-elevation myocardial infarction (STEMI).
- The STEMI was attributed to an embolism in the right main coronary artery.
- The patient had a history of a bioprosthetic aortic valve and atrial fibrillation.
Findings:
- The case highlights the complexity of diagnosing coronary embolism in patients with specific cardiac histories.
- Management strategies for coronary embolism must be individualized based on clinical context.
- The patient received an implantable loop recorder for further therapeutic decision-making.
Implications:
- This case underscores the importance of considering coronary embolism in ACS, particularly in high-risk patients.
- Implantable loop recorders can aid in identifying the source of embolic events and guiding long-term management.
- Further research into the optimal management of coronary embolism in specific patient populations is warranted.
Abstract:
Coronary embolism is a rare cause of acute coronary syndrome. We report the challenging case of a 68-year-old female with ST-elevation myocardial infarction caused by right main coronary artery embolism in the setting of bioprosthetic aortic valve and previous episode of atrial fibrillation. The management of coronary embolism depends on the patient clinical setting. In this case, the patient has received an implantable loop recorder before discharge to decide the following therapy.
