title: Acute myocardial infarction caused by embolism of thrombus in the right coronary sinus of Valsalva: a case report and review of the literature.
abstract: A 56-year-old man presented with sustained chest pain. Coronary angiography revealed total occlusion of the distal right coronary artery and left anterior descending branch. Left ventriculography depicted a mobile mass in the right sinus of Valsalva originating from the ostium of the right coronary artery. Transesophageal echocardiography (TEE) showed a mobile mass in the sinus of Valsalva and another mobile mass in the aortic arch. The mass at the right sinus of Valsalva was surgically resected, and histologic examination revealed an organized thrombus. Coagulation study showed protein S deficiency. This is the first case of acute myocardial infarction as a result of multiple coronary embolism caused by thrombosis in the right sinus of Valsalva with a second aortic arch thrombosis, contributed by protein S deficiency.
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 2-5-4 Yoyogi, Shibuyra-ku, Tokyo 515-0053, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Eguchi
authors.forename: Eiji
authors.initials: E
authors.lastname: Ohtaki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Misu
authors.forename: Masaru
authors.initials: M
authors.lastname: Aikawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.forename: Saichi
authors.initials: S
authors.lastname: Hosoda
authors.forename: Toshiya
authors.initials: T
authors.lastname: Koyanagi
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000150:complications / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin