Isolated Septal Branch Occlusion Causing Septal Myocardial Infarction, With Suspected Embolic Etiology From Left...

Area of Science:

• Cardiology
• Internal Medicine
• Thrombosis Research

Background:

• Atrial fibrillation (AF) is a common arrhythmia associated with an increased risk of thromboembolism.
• The left atrial appendage (LAA) is a frequent source of thrombus formation in patients with AF.
• Managing anticoagulation in patients with multiple allergies and complex medical histories presents significant challenges.

Purpose of the Study:

• To report a rare case of isolated septal myocardial infarction (MI) caused by an LAA thrombus.
• To emphasize the importance of adherence to anticoagulation therapy in AF patients.
• To discuss the clinical management of patients with AF, LAA thrombus, and medication intolerances.

Main Methods:

• Case report presentation.
• Review of patient's medical history, including AF, allergies, and medication adherence.
• Echocardiographic and electrocardiographic analysis to diagnose septal MI and identify LAA thrombus.

Main Results:

• A 76-year-old female with AF and a self-discontinued anticoagulation regimen developed an isolated septal MI.
• The MI was attributed to an embolic occlusion of the septal branch, originating from a thrombus within the LAA.
• The patient's complex history of allergies complicated treatment options.

Conclusions:

• This case highlights a rare embolic event leading to septal MI in an AF patient.
• Consistent and appropriate anticoagulation is crucial for preventing LAA thrombus and subsequent embolic events in AF.
• Careful consideration of patient history, including allergies and adherence, is vital for effective anticoagulation management in AF.