June 2020 Vol. 8 No.6

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Case Report

A case of acute myocardial infarction without coronary artery disease: what else could it be?

Plamen K. Krastev¹, Stefan N. Naydenov² and Emil I. Manov³

¹Assistant professor at UMBAL “St. Ekaterina”, Medical University of Sofia, Bulgaria
²Associate professor at the Department of Internal Diseases “Prof. St. Kirkovich”, Medical University of Sofia, Bulgaria
³Associate professor at the Department of Internal Diseases “Prof. St. Kirkovich”, Medical University of Sofia, Bulgaria

*Corresponding Author's E-mail: snaydenov@gmail.com
Mobile: +359 888 52 84 17
Fax: +359 2 92 30 658

Received: 06 June 2020  I  Accepted: 24 June 2020  I  Published: 28 June 2020  I  Article ID: MRJMMS-20-094
Copyright © 2020 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0.

Abstract

Coronary embolism of non-cardiac origin is a rare cause for acute myocardial infarction. A 93-year-old female patient was admitted to our hospital for acute chest pain, persistent ST-segment elevation in the inferior electrocardiographic leads and elevated troponin T. The emergency coronary angiography showed total occlusion of the postero-lateral branch of the right coronary artery. Thrombaspiration was performed and coronary blood flow was completely restored. Surprisingly, the evacuated material was not thrombotic; the histologic analysis revealed metastatic embolus from an adenocarcinoma. The subsequent computed tomography of the chest and the additional investigations confirmed the primary source of the coronary embolism: lung adenocarcinoma. Coronary embolism due to a metastatic lung cancer is a rare, but possible cause for acute myocardial infarction. Thrombaspiration is a successful method for treatment of the acute coronary occlusion and provides material for identifying the primary source of the emboli.

Keywords: Adenocarcinoma, Coronary, Embolism, Metastasis, Thrombaspiration