STEMI can present atypically as acute limb ischemia due to distal embolization from a left ventricular thrombus.
Delayed STEMI with ventricular thrombus can cause limb ischemia; single case leaves open need for cardiac evaluation protocols.
We describe a case of delayed presentation of ST-segment elevation myocardial infarction (STEMI) complicated by ventricular thrombus and peripheral embolization causing limb ischemia. Our patient initially presented with symptoms of acute limb ischemia. However, on preoperative evaluation, STEMI was diagnosed. He required emergent revascularization of the left anterior descending artery followed by thrombectomy of the femoral artery. The cause of the limb ischemia was deemed to be a late presenting STEMI that was complicated by left ventricular thrombus, hence causing lower extremity embolization. Delayed presentations and complications related to STEMI may manifest as acute limb ischemia in the setting of ventricular thrombus formation and subsequent distal embolization.
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Ahmed et al. (2020) studied this question.
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