Acute Coronary Embolism in a Patient with Multiple Mechanical Prosthetic Valves

Coronary embolism leading to acute myocardial infarction (MI) is a rare occurrence in patients with mechanical and tissue prosthetic valves and has been reported usually in patients with a single valve prosthesis. The usual therapeutic strategy has been thrombosuction with or without plain balloon angioplasty and experience with coronary stenting in such cases is limited. A young female with mechanical aortic and mitral prosthetic valves discontinued oral anticoagulation (OAC) 3 months prior and sustained an acute ST-elevation anterior MI. The patient stopped OAC voluntarily (a not infrequent occurrence in the developing world, primarily due to lack of knowledge and ignorance on part of the patients). Although she had been advised to obtain regular follow-up in the valve clinic, she discontinued these visits, also of her own volition. While both prosthetic valves were functioning normally, coronary angiography revealed a mid 100% occluded left anterior descending artery (LAD) that was successfully stented.

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See the associated article, "'A Hit and a Miss': Acute Coronary Embolism in a Patient with Multiple Mechanical Prosthetic Valves."