Case Report

Acute Coronary Syndrome (ACS) due to Coronary Artery Embolism in a Patient with Atrial Fibrillation

Table 1

Reported cases of coronary artery embolism with embolus location and outcomes.

AuthorPatient agePatient genderHistory of atrial fibrillation or flutterPeak troponinEmbolus locationOutcomesReferences

Antoine et al.58MYes.Troponin I 9.56 (unknown units).Distal left circumflex artery (LCX).NSTEMI managed by embolectomy.[12]

Camaro et al.66FYes, new-onset.Unknown.Distal right coronary artery (RCA).STEMI managed conservatively with anticoagulation after failed PCI.[13]

Diaz et al.52MYes, new-onset.Troponin I 0.6 ng/mL ().Proximal left anterior descending artery (LAD).NSTEMI managed by thrombectomy.[14]

Everett et al.30MNo.Unknown.Distal LAD.Acute coronary syndrome managed by thrombectomy and anticoagulation.[9]

Garg et al.53FNew-onset atrial fibrillation.Troponin T 5.0 ng/mL ().Posterolateral branch of the LCX.NSTEMI managed with anticoagulation.[15]

Kotooka et al.88FYes.Unknown.Proximal RCA.STEMI managed by thrombectomy.[16]
50MNo.Unknown.Ostium of RCA.STEMI treated by thrombus aspiration.
85MYes.Unknown.Left main coronary artery (LCA).STEMI complicated by cardiogenic shock, managed by dobutamine and an intra-aortic balloon pump and subsequently a thrombectomy and stent placement.

Koutsampasopoulos et al.69FYes.High sensitivity troponin T 5.33 ng/L ().Midsegment of LAD.STEMI managed with thrombectomy.[17]

Nakano et al.82FYes.Troponin I 0.65 ng/mL.Unclear. ECG showed atrial fibrillation, an inverted T wave in V1-V3, an abnormal Q wave in V1 -V4, and ST-segment elevation in V3 and V4.The patient was too unstable for an angiogram, thus was treated with intravenous heparin but died within 24 hours (diagnosis suspected by criteria proposed by Shibata et al.).[11]

OSullivan et al.70MPerioperative atrial fibrillation after noncardiac surgery with subsequent embolization.High sensitivity troponin T 0.540 μg/L ().Complete occlusion of RCA up to ostium.STEMI managed with thrombectomy.[18]

Sakai et al.72MYes.Unknown, CKMB peaked at 2929 IU/L ().Proximal RCA.STEMI managed by thrombectomy.[19]

Takenaka et al.65FYes.Unknown.Distal LAD.STEMI managed by balloon angioplasty and thrombolysis.[20]

Van de Walle et al.64MYes.Unknown.Midsegment of LAD.STEMI managed by stenting.[1]

Zakaria et al.65FNew-onset atrial flutter.Unknown.Origin of LCX.NSTEMI managed by thrombectomy.[21]