Key result
Rare-source coronary embolism causes ACS in young patients, requiring etiology-tailored management.
Why the study?
Coronary embolism is an uncommon, non-atherosclerotic cause of ACS that is frequently under-recognized.
Case Report (n=3)
Coronary embolism should be considered in young patients presenting with acute coronary syndrome without atherosclerotic risk factors, requiring multimodality imaging for diagnosis and individualized management.
May prompt evaluation for rare embolic sources in young ACS; leaves optimal strategies open pending prospective data.
Background Coronary embolism is an uncommon, non-atherosclerotic cause of acute coronary syndrome(ACS) and is frequently under-recognized. We describe three rare presentations of coronary embolism causing ACS in young patients. Cases summary Case 1-A 23-year-old male developed inferior wall myocardial infarction due to septic coronary embolism complicated by basal inferior submitral aneurysm, mitral valve infective endocarditis with anterior mitral leaflet(AML) perforation. He underwent mitral valve replacement and aneurysm repair. Case 2-A 35-year-old male presented with acute inferior wall myocardial infarction secondary to tumour embolism from left atrial myxoma and underwent mass excision, mitral annuloplasty, and coronary artery bypass grafting. Case 3-A 38-year-old female with Non ST elevation myocardial infarction and severe mitral stenosis demonstrated probable coronary embolism without atrial fibrillation(AF) or left atrial appendage(LAA) thrombus and was managed with anticoagulation and planned percutaneous trans-mitral commissurotomy. Discussion The etiology and source for coronary embolism in majority of the non-atherosclerotic ACS patients become clear from past symptoms in history and cardiovascular imaging. The treatment in most cases of coronary embolism depends on the site of obstruction i.e. distal branch vessel vs proximal vessel obstruction and also the nature of suspected embolic material. Aspiration thrombectomy and anticoagulation remains the mainstay in majority of thrombo-embolic lesions whereas non thrombotic lesions need to be managed on an individualized approach. Conclusion Coronary embolism should be considered among the differential diagnoses of MINOCA (Myocardial infarction with non-obstructive coronary arteries) and ACS in young patients without significant atherosclerotic disease, particularly when an embolic substrate is identifiable.
No takes yet. Share an insight, caveat, or question.
Gopidi et al. (2026) conducted a case report in Acute coronary syndrome due to coronary embolism (n=3). Non-atherosclerotic coronary embolism was evaluated on Clinical presentation and management outcomes. Coronary embolism from rare sources like infective endocarditis, atrial myxoma, and rheumatic heart disease can cause acute coronary syndrome in young patients and requires individualized management.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: