Coronary artery disease: not always the case for ST-elevation myocardial infarction.
We report a case of an acute ST-T elevation myocardial infarction in a middle-aged female with a mechanical mitral valve prosthesis and subtherapeutic INR levels. We performed a primary coronary intervention, using a thromboaspiration catheter. After blood clot aspiration, a TIMI III flow was restored and no residual lesions remained at the site of the occlusion. A transesophageal echo revealed a movable thrombus over the mechanical mitral valve prosthesis and patient underwent subsequent mitral valve replacement. Embolic myocardial infarction remains underdiagnosed. A high level of suspicion and the quest of the source of embolus are crucial.
Cardiac Catheterization Laboratory, Thriassio General Hospital of Elefsis, Athens, Greece. annadagre@hotmail.com
Anna
A
Dagre
Nikos
N
Kouris
Christopher
C
Olympios
D003324:Coronary Artery Disease / Q000150:complications*; D054059:Coronary Occlusion / Q000150:complications* / Q000628:therapy; D004562:Electrocardiography; D004617:Embolism / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D062645:Percutaneous Coronary Intervention; D013396:Suction; D016896:Treatment Outcome