Why the study?
Coronary artery embolism is a rare cause of acute myocardial infarction with an unknown exact prevalence and is associated with conditions leading to thromboembolism such as atrial fibrillation.
Discontinuation of anticoagulation in patients with atrial fibrillation can lead to rare but severe complications such as coronary artery embolism, which can be successfully managed with aspiration thrombectomy.
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.
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Abbasi et al. (2020) studied this question.
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