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Case Reports in Medicine
Volume 2010 (2010), Article ID 751857, 4 pages
http://dx.doi.org/10.1155/2010/751857
Case Report

Acute Myocardial Infarction due to Coronary Artery Embolism in a Patient with Mechanical Aortic Valve Prosthesis

1Department of Cardiology and Cardiovascular Surgery, São José do Rio Preto Medical School, CEP 15090-000, São José do Rio Preto, SP, Brazil
2Department of Molecular Biology, São José do Rio Preto Medical School, Av. Brigadeiro Faria Lima 5416, CEP 15090-000, São José do Rio Preto, SP, Brazil

Received 29 November 2009; Revised 28 March 2010; Accepted 4 May 2010

Academic Editor: Grigorios Korosoglou

Copyright © 2010 Marcelo A. Nakazone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Previous cases of coronary embolism as a cause of myocardial infarction (MI) in association with prosthetic mechanical valves have been reported, but the fact that the patient was not aware of the importance of maintaining anticoagulation therapy is relevant in this case. A 16-year-old female was referred for primary coronary intervention due to subacute anterolateral ST elevation MI, after she decided to discontinue warfarin therapy three weeks before. Coronary angiography showed distal occlusion of the left anterior descending coronary artery with an image suggesting embolic material. Conventional echocardiography demonstrated akinesia of anteroseptal, inferior, and posterior segments of the left ventricle, with severe systolic dysfunction, beyond the intraventricular thrombus. The presence of mechanic aortic prosthesis and no anticoagulation therapy are highly suggestive of coronary embolism as the cause of MI. This case report confirms that patient education is vital in our struggle to prevent this complication in high-risk patients.