Work

Multimodal Image in a Coronary Embolism–Induced Acute Myocardial Infarction in a Mechanical Aortic Valve Recipient

Year: 2025

Type: article

Abstract: BACKGROUND: Coronary embolism is an uncommon etiology of acute myocardial infarction, particularly in patients with mechanical heart valves. CASE: A 47-year-old woman with mechanical aortic valve replacement presented with non-ST-segment elevation myocardial infarction after temporary warfarin interruption. Computed tomography angiography and coronary angiography revealed a mobile thrombus in the mid-left anterior descending artery, which was confirmed as embolic origin by intravascular ultrasound. MANAGEMENT: Initial thrombus aspiration yielded suboptimal results. Subsequent balloon angioplasty was performed, achieving TIMI flow grade 3 restoration. Anticoagulation therapy with warfarin was reinitiated for long-term management. CONCLUSIONS: This case highlights the critical role of intravascular imaging in diagnosing embolic acute myocardial infarction and the efficacy of mechanical thrombus modification when thrombus aspiration alone is inadequate.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104659