Acute Anterior ST-Segment Elevation Myocardial Infarction Due to Left Atrial Myxoma Embolization

Cardiac myxoma is the most common primary cardiac tumor. Although it is histologically benign, it can cause systemic or coronary embolization.

A 54-year-old woman with no traditional cardiovascular risk factors presented with anterior ST-segment elevation myocardial infarction (STEMI). Emergent coronary angiography revealed complete occlusion of the mid-left anterior descending artery without atherosclerosis. Aspiration thrombectomy restored TIMI flow grade 3; intravascular ultrasound excluded plaque rupture or dissection. Histopathologic analysis of the aspirated material demonstrated myxoid tissue consistent with cardiac myxoma. Multimodality imaging confirmed a pedunculated left atrial mass, and surgical excision was performed.

STEMI caused by myxoma embolization is rare and likely underrecognized. This case emphasizes the embolic mechanism of coronary occlusion, the importance of urgent reperfusion and intravascular ultrasound, and the need for definitive surgical resection to prevent recurrence.

Coronary embolism should be considered in STEMI without traditional cardiovascular risk factors. Intravascular imaging helps exclude plaque rupture. Definitive treatment requires tumor excision.