Myocardial Infarction Due to Coronary Artery Embolism in a Patient with a Mechanical Mitral Valve: A Case Report

Sara Abouradi *

Department of Cardiology, Ibn Rochd Hospital University, Casablanca, Morocco.

Asmaa Elamraoui

Department of Cardiology, Ibn Rochd Hospital University, Casablanca, Morocco.

Zineb Eljaouhari

Department of Cardiology, Ibn Rochd Hospital University, Casablanca, Morocco.

Salim Arrous

Department of Cardiology, Ibn Rochd Hospital University, Casablanca, Morocco.

Ghali Bennouna

Department of Cardiology, Ibn Rochd Hospital University, Casablanca, Morocco.

Rachida Habbal

Department of Cardiology, Ibn Rochd Hospital University, Casablanca, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Background: Mechanical valves are inherently thrombogenic and require meticulous anticoagulation. Thrombosis of cardiac valve prostheses is a dangerous complication, that practitioners should clearly explain to their patients the potential risks of stopping treatment.

Case Presentation: A 48-year-old female patient without any cardiovascular risk factor with a history of mechanical prosthesis for rhumatic mitral stenosis, who stopped anticoagulant treatment for dental extraction, admitted for Ischemic cerebral vascular accident complicated during her hospitalization by supraventricular tachycardia with a coronary embolism leading to an ST segment elevation due to an non obstructive thrombus causing embolic acute myocardial infarction.

Conclusions: Education regarding an adequate anticoagulation in these patients is important. Clinicians should keep in mind the importance of providing to their patients all the informations concerning the potential risks of stopping their treatment.

Keywords: Mechanical valves, thrombosis of prosthesis, anticoagulation, case report


How to Cite

Abouradi , Sara, Asmaa Elamraoui, Zineb Eljaouhari, Salim Arrous, Ghali Bennouna, and Rachida Habbal. 2023. “Myocardial Infarction Due to Coronary Artery Embolism in a Patient With a Mechanical Mitral Valve: A Case Report”. Asian Journal of Cardiology Research 6 (1):63-67. https://journalajcr.com/index.php/AJCR/article/view/137.

Downloads

Download data is not yet available.

References

Wenger KN, Bauer S. Coronary embolism. review of the literature and presentation of 15 cases. Am J Med. 1958;25:549-57.

Alpert JS. The thrombosed prosthetic valve. J am Coll Cardiol 2003:41:659:60.

Tong TA, Roudout R, Ozkan M, et al. On behalf of the prosthetic valve thrombolysis – role of transoesophageal echocardiography (pro-tee) regisry invistigators/ transoesophageal echocardiography improves risk assessment of thrombolysis of prosthetic valve thrombosis: Results of the international pro-tee registry. J Am Coll Cardiol. 2004:43:77-84.

Prizel KR, Hutchins GM, Bulkley BH. Coronary artery embolism and myocardial infarction, a clinicopathologic study of 55 patients. Ann Intern Med. 1978;88:155-61.

Hassouna A, El-Ghanam M, Moftah H, Samir K, Refaat K. Index of deterioration of patients with mechanical prosthetic heart valve thrombosis. The Cardiothoracic Surgeon. 2020;28(1):1-1.

Bezanjani FN, Gohari S, Bassiri HA, Ahangar H, Reshadmanesh T. Risk factors associated with heart valve thrombosis in patients with prosthetic heart valve dysfunction. Archives of Iranian Medicine. 2020;23(9):600-4.

Gully C, Baron O, Nguyen Khal O. et al, Coronary embolism: a not so rare cause of myocardial infarction? Review of the literature about five suspected cases of patients in atrial fibrillation. Ann Cardiol Angeiol. 2008;57:290-94.

Cannegiester SC, Rosendaal FR, Brier E. Thromboembolic and bleeding complications in patients with mechanical heart valve prosthesis. Circulation. 1994;89:635-41.

Aslam MS, Sanghi V, Hersh S, Lakier JB. Embolie coronarienne en selle et infarctus du myocarde chez un patient porteur d'une valve mitrale prothétique. Cathétérisme et Interventions Cardiovasculaires. 2002;57(3):367–370.

Charles RG, Epstein EJ, Holt S, Coulshed N. Coronary embolism in valvular heart disease. Q J Med. 1982;51:147-61

Waller BF, Dixon DS, Kim RW, Roberts WC. "Embolus to the left main coronary artery." Journal Américain De Cardiologie. 1982;50(3):658–660.

Cannegiester SC, Rosendaal Fr , Winten AR, Van der Meer FJM, Vandenbrouke JP, Brier E. Optimal oral anticoagulant therapy in patients with mechanical heart valves. NEJM. 1995;333:11-7.

Srilakshmi MA, Shetty GG, santosh MJ, et al. Acute st elevation myocardial infarction in a patient with caged ball mitral valve prosthesis: A case report. International Journal of Cardiology. 2008;128:e101–e103.

M. Dogan, S. Acikel, Aksoy, et al. Embolie coronarienne en selle provoquant un infarctus du myocarde chez un patient MMN porteur d'une prothèse de valve mitrale mécanique : traitement par thérapie thrombolytique. Journal International De Cardiologie, 2009;135(2):e47-e48.

Kiernan TJ, Flynn AM, Kearney P. Coronary embolism causing myocardial infarction in a patient with mechanical aortic valve prosthesis. International Journal of Cardiology. 2006;112:e14–e16.

Lavoie P, Leduc L, Mercier LA. Infarctus du myocarde embolique chez une femme enceinte porteuse d'une valve cardiaque mécanique sous héparine de bas poids moléculaire. Journal Canadien De Cardiologie. 2004;20(9):917–919.