Coronary Artery Ectasia Presenting with Thrombus Embolization and Acute Myocardial Infarction: A Case Report
Overview
Authors
Affiliations
Rationale: Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. CAE is often associated with the presence of slow coronary flow and may lead to acute myocardial infarction (AMI), even without total occlusion.
Patient Concerns And Diagnosis: We report a case of a 24-year-old male patient with CAE suffering from AMI.
Interventions: Percutaneous coronary intervention with aspiration thrombectomy failed to restore adequate blood flow. Heparin and antiplatelet treatment were provided for pharmacological management, but follow-up angiography 15 days later still revealed a poor result. This patient was ultimately treated with antiplatelet therapy in combination with warfarin treatment.
Outcomes: Follow-up coronary angiography 15 months later showed a restored normal Thrombolysis In Myocardial Infarction grade (TIMI) 3 flow.
Lessons: CAE-related infarct is often associated with high-burden thrombus formation. Long-term warfarin in combination with antiplatelet therapy may be a good alternative intervention to decrease thrombus burden and enhance blood flow.
Increased serum resistin levels associated with isolated coronary artery ectasia.
Sivri F, Eryilmaz U Arch Med Sci Atheroscler Dis. 2022; 7:e124-e130.
PMID: 36158069 PMC: 9487800. DOI: 10.5114/amsad/151954.
Wu Y, Liu Y, Chao M, Dai Z, Chen I, Lo S Front Cardiovasc Med. 2022; 9:898914.
PMID: 36003905 PMC: 9393260. DOI: 10.3389/fcvm.2022.898914.
Apixaban for massive intracoronary thrombosis: A case series.
Esenboga K, Sahin E, Ozyuncu N, Tan T, Atmaca Y Anatol J Cardiol. 2021; 25(9):661-664.
PMID: 34498598 PMC: 8443197. DOI: 10.5152/AnatolJCardiol.2021.32746.
A pebble clogging a river: a case report of thrombosed coronary aneurysmal ectasia.
Jaglan A, Ajam T, Port S, Bajwa T, Tajik A Eur Heart J Case Rep. 2021; 4(6):1-5.
PMID: 33628993 PMC: 7891237. DOI: 10.1093/ehjcr/ytaa274.
Low High-Density Lipoprotein Cholesterol Predisposes to Coronary Artery Ectasia.
Jafari J, Daum A, Hamed J, Osherov A, Orlov Y, Yosefy C Biomedicines. 2019; 7(4).
PMID: 31591337 PMC: 6966440. DOI: 10.3390/biomedicines7040079.