This case report demonstrates that paroxysmal atrial fibrillation can cause recurrent coronary embolism and myocardial infarction, emphasizing the need for oral anticoagulation even in patients with a low CHADS2 score.
Documents recurrent MI from paroxysmal AF embolism; hypothesis-generating for anticoagulation in low CHADS2 patients.
Coronary thromboembolism with subsequent myocardial infarction is a rare complication of atrial fibrillation. The authors present the history of a 55-year-old male with a history of acute myocardial infarction caused by thromboembolism in the distal part of left anterior descending coronary artery and paroxysmal atrial fibrillation, who presented one year later with new chest pain, ST-segment elevation and atrial fibrillation. Coronarography confirmed the presence of thrombus in the circumflex coronary artery. Transesophageal echocardiogram showed left atrial appendage thrombus. To the knowledge of the authors this is the first report of recurrent myocardial infarction caused by atrial fibrillation.
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Tomcsányi et al. (2016) studied this question.
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