Key result
Conservative triple antiplatelet therapy resolves left main thrombus in a young adult with acute MI.
Case Report (n=1)
Conservative management with triple antiplatelet therapy successfully resolved an extensive left main stem thrombus in a hemodynamically stable young adult with anabolic steroid abuse.
May support conservative management in stable anabolic steroid-associated MI; leaves open need for larger studies on causality and therapy.
We present a case of acute myocardial infarction in a young adult with a history of anabolic steroid abuse. On diagnostic coronary angiography and intravascular ultrasound, he was found to have a distal left main stem thrombus extending into the proximal left anterior descending artery and a large intermediate vessel. As he was hemodynamically stable and pain-free, he was managed conservatively with triple antiplatelet therapy (aspirin, clopidogrel, and abciximab). This was also to avoid the risk of 'wiring the vessel,' especially if there was underlying dissection. Repeat angiography a few weeks later showed complete thrombus resolution. This is the first reported case of extensive left main stem thrombus in a young patient with anabolic steroid abuse. Management of such cases is not straightforward and our case highlights one approach to both diagnosis and treatment.
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Garg et al. (2010) conducted a case report in Acute myocardial infarction with left main stem thrombus (n=1). Conservative management with triple antiplatelet therapy (aspirin, clopidogrel, and abciximab) was evaluated on Thrombus resolution. Conservative management with triple antiplatelet therapy led to complete thrombus resolution in a young adult with acute myocardial infarction and left main stem thrombus.
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