Key result
Coronary embolism causes anterior STEMI in a 60-year-old woman with paroxysmal AF and prior stroke.
Why the study?
Coronary embolism is a rare cause of acute STEMI that can be induced by conditions such as atrial fibrillation.
Case Report (n=1)
Coronary embolism should be considered as a rare cause of acute STEMI, particularly in patients with a history of atrial fibrillation and prior embolic events.
May prompt consideration of coronary embolism in AF-related STEMI; leaves open need for prospective validation.
Introduction: Coronary embolism (CE) is a rare cause of acute ST-elevation myocardial infarction (STEMI). Atrial fibrillation (AF), left ventricular thrombus, septic emboli from infective endocarditis, myxoma, and paradoxical embolism can induce emboli in coronary arteries. Case presentation: Here we present a case of anterior wall STEMI secondary to paroxysmal AF in a 60-years-old female with a previous history of right-sided ischemic stroke. Discussion: The major criteria for diagnosis of coronary embolism include (1) non-atherosclerotic wall of coronary vessels under angiography; (2) concomitant involvement of multiple sites; (3) histological proof of venous thrombus; (4) imaging by echocardiography/CT/MRI showing intra-cardiac thrombus. The minor criteria include (1) <25% stenosis of other vessels supplying to infarct-free myocardium; (2) atrial fibrillation history; (3) risk factors like (prosthetic valve, bacterial endocarditis, patent foramen ovale, atrial septal defect, dilated cardiomyopathy). Conclusion: Our case highlights the importance of cardiac embolus as a diagnosis in a patient with a history of stroke secondary to atrial fibrillation as a cause of acute STEMI and its management.
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Shah et al. (2022) conducted a case report in Anterior wall STEMI secondary to paroxysmal atrial fibrillation due to coronary embolism (n=1). Coronary embolism was evaluated. A 60-year-old female with a history of ischemic stroke and paroxysmal atrial fibrillation presented with an anterior wall STEMI caused by a coronary embolism.
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