Abbasi Danish, Salehi Negar, Faiek Saif, Siddiqui Waqas J, Ahmad Shahzed
Cardiovascular Diseases, University of Arkansas, Little Rock, USA.
Internal Medicine - Cardiology, University of Arkansas, Little Rock, USA.
Cureus. 2020 Aug 27;12(8):e10082. doi: 10.7759/cureus.10082.
Coronary artery embolism (CAE) is a rare clinical entity that can cause acute myocardial infarction (AMI). The exact prevalence of coronary artery embolism is unknown. CAE was found to be associated with conditions that can lead to thrombo-embolism, including infective endocarditis, atrial fibrillation, mitral valve disease, valve surgery. Herein, we report a 78-year-old male with a past medical history of atrial fibrillation on rivaroxaban who presented to the hospital emergency department complaining of chest pain. The patient's anticoagulation therapy was recently held due to a concern for gastrointestinal bleeding. After further evaluation of the patient's symptoms and reviewing his electrocardiogram (ECG) which showed ST-depression in lateral leads and ST-elevation in aVR, urgent cardiac catheterization was done which showed left main coronary artery thrombosis extending into the left anterior descending artery (LAD) and left circumflex artery (LCX). The patient was started on a heparin drip and underwent a successful aspiration thrombectomy with subsequent improvement in his symptoms.
冠状动脉栓塞（CAE）是一种可导致急性心肌梗死（AMI）的罕见临床病症。冠状动脉栓塞的确切患病率尚不清楚。已发现CAE与可导致血栓栓塞的病症相关，包括感染性心内膜炎、心房颤动、二尖瓣疾病、瓣膜手术。在此，我们报告一名78岁男性，既往有房颤病史，正在服用利伐沙班，因胸痛到医院急诊科就诊。由于担心胃肠道出血，患者最近停用了抗凝治疗。在对患者症状进行进一步评估并查看其心电图（ECG）显示侧壁导联ST段压低、aVR导联ST段抬高后，进行了紧急心脏导管插入术，结果显示左主干冠状动脉血栓延伸至左前降支动脉（LAD）和左旋支动脉（LCX）。患者开始静脉滴注肝素，并成功进行了抽吸血栓切除术，随后症状有所改善。
