Hypertrophic cardiomyopathy complicated with acute myocardial infarction due to coronary embolism

Area of Science:

• Cardiology
• Interventional Cardiology

Background:

• Hypertrophic cardiomyopathy is a condition that can predispose patients to thromboembolic events.
• Coronary artery embolism is a rare but serious cause of acute myocardial infarction.

Observation:

• A patient with hypertrophic cardiomyopathy presented with acute myocardial infarction.
• Echocardiography revealed hypertrophic cardiomyopathy, and coronary arteriography showed embolic occlusion in the left circumflex and diagonal coronary arteries.
• Transesophageal echocardiography identified thrombus in the left atrial appendage.

Findings:

• Emergency coronary arteriography diagnosed embolic occlusion of the left circumflex coronary artery and first diagonal branch.
• Successful treatment included intracoronary thrombolysis with urokinase and balloon angioplasty.
• Follow-up angiography demonstrated patent coronary arteries, with complete resolution of the occlusion.

Implications:

• This case highlights coronary embolism as a potential cause of myocardial infarction in hypertrophic cardiomyopathy.
• Timely diagnosis and intervention, including thrombolysis and angioplasty, can lead to favorable outcomes.
• Identifying and treating the source of embolism, such as left atrial appendage thrombus, is crucial for preventing recurrence.