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Atrial Fibrillation as a Potential Risk for ST-Segment Elevation Myocardial Infarction

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Authors
Park, Seung-Jung; Youn, Tae-Jin; Oh, Il-Young; Kim, Kyung-Hee; Yang, Han-Mo; Cho, Goo-Yeong; Choi, Dong-Ju; Chun, EunJu; Kim, Ji-Hyun
Issue Date
2010-06-08
Publisher
ELSEVIER SCIENCE INC
Citation
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY; Vol.55 23; E141-E141
Abstract
An 83-year-old woman presented with dyspnea that had developed 5 days earlier. Electrocardiography
suggested ST-segment elevation myocardial infarction with underlying
rhythm of atrial fibrillation (A). Angiography revealed multiple large filling defects
in the mid-left anterior descending (LAD) artery and diagonal branch with sluggish
coronary flow (B, Online Video 1). Intravascular ultrasound scanning performed after thrombosuction
demonstrated only minimal plaque burden with intact intima throughout the LAD,
favoring coronary embolization rather than in situ thrombotic occlusion as the cause of this
infarction (C). Although mobile echogenic masses (1.0 2.0 cm) in the left atrial appendage
(LAA) were suspected on transesophageal echocardiography, the presence of thrombi was
slightly inconclusive (D, Online Videos 2 and 3). On arterial phase computed tomography angiograms,
a large filling defect in the dilated LAA was detected, which could be caused by
blood stasis or thrombi (E, F). This filling defect was, however, persistent on the additional
delayed images (G), providing additional evidence of the presence of thrombi (1). She received
an anticoagulation therapy after thrombosuction instead of dual-antiplatelet treatment along
with stent implantation.
ISSN
0735-1097
Language
English
URI
https://hdl.handle.net/10371/77514
DOI
https://doi.org/10.1016/j.jacc.2009.09.077
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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