Calcific embolus resulting in ST elevation myocardial infarction: A rare complication of mitral annular calcification

Abstract Background Caseous mitral annular calcification is an under-diagnosed division of calcific mitral valve disease that has recently been reported to have increased propensity for embolic disease. Early recognition of this entity as a cause of embolic disease can lead to prevention of occlusive vascular disease and long-standing complications. Case Summary We present the case of a patient with end-stage renal disease who presented for evaluation of chest pain and was found to have ST-segment myocardial infarction. Despite thrombectomy and stenting, he had multiple recurrent events, and imaging evaluation demonstrated caseous mitral annular calcification with mobile components. He was taken for surgical replacement of the mitral valve, with pathology confirming diagnosis. Discussion Caseous mitral annular calcification may represent an increased risk of embolic disease. Better understanding of this pathology and it’s propensity for embolic disease will be important to best determine treatment plans and timing of operative intervention.

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A Case of Cardiac Calcified Amorphous Tumor Presenting with Concomitant ST-Elevation Myocardial Infarction and Occipital Stroke and a Brief Review of the Literature

Case Reports in Cardiology ◽

10.1155/2017/8578031 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Kyaw Kyaw ◽

Htun Latt ◽

Sammy San Myint Aung ◽

Chanwit Roongsritong

Keyword(s):

Myocardial Infarction ◽

St Elevation Myocardial Infarction ◽

Cardiac Tumors ◽

Review Of The Literature ◽

Limited Data ◽

Systemic Embolization ◽

St Elevation ◽

Calcified Amorphous Tumor ◽

Annular Calcification

Cardiac calcified amorphous tumor (CAT) is an extremely rare benign intracavitary tumor of the heart. It may mimic other cardiac tumors and can present with signs or symptoms of systemic embolization. There are limited data regarding CAT in the literature. We report a case of a 68-year-old woman with a cardiac CAT and mitral annular calcification (MAC), who presented with acute ST-elevation myocardial infarction (STEMI) and occipital stroke. After extensive review of the literature, we believe that this case is possibly the first description of a cardiac CAT presenting with STEMI. The CAT was surgically removed, and the diagnosis was confirmed by histology. The patient tolerated the surgery and reported no events at 6-month follow-up.

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Acute Myocardial Infarction in Snake bite Envenomation A Case Report

Journal of Medicine ◽

10.3329/jom.v16i1.22401 ◽

2015 ◽

Vol 16 (1) ◽

pp. 46-47

Author(s):

NS Neki

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Case Report ◽

Chest Pain ◽

Rare Complication ◽

Snake Bite ◽

St Elevation Myocardial Infarction ◽

History Of ◽

Electrocardiographic Changes ◽

St Elevation

Snake bite envenomation is a common problem in tropical countries, especially in rural parts of India. We came across a 30 year old male who presented to the hospital after 4 hours with history of Russells viper snake bite developing acute non ST elevation myocardial infarction (MI). Myocardial infarction was confirmed by history of left sided chest pain radiating to left arm with diaphoresis and electrocardiographic changes with increased serum troponin levels. Myocardial infarction is a rare complication of snake bite hence case report.DOI: http://dx.doi.org/10.3329/jom.v16i1.22401 J MEDICINE 2015; 16 : 46-47

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Non-ST-elevation myocardial infarction following foam ultrasound-guided sclerotherapy

Phlebology The Journal of Venous Disease ◽

10.1177/0268355513481765 ◽

2013 ◽

Vol 29 (7) ◽

pp. 488-490 ◽

Cited By ~ 6

Author(s):

R Stephens ◽

S Dunn

Keyword(s):

Myocardial Infarction ◽

Unusual Case ◽

Rare Complication ◽

Relevant Literature ◽

Coronary Artery Spasm ◽

Myocardial Damage ◽

Paradoxical Embolism ◽

St Elevation Myocardial Infarction ◽

Ultrasound Guided ◽

St Elevation

The objective of the study was to describe a very rare complication of foam ultrasound-guided sclerotherapy (FUGS). An unusual case of persisting chest discomfort following FUGS in a 61-year-old woman led to a diagnosis of non-ST-elevation myocardial infarction. The patient was found to have a patent foramen ovale (PFO). The differential diagnoses of paradoxical embolism, gas embolism or vasospasm are discussed, with reference to relevant literature. A hypothesis of post sclerotherapy release of endothelin-1 (in a patient with a known PFO) leading to sustained coronary artery spasm causing sufficient myocardial damage to be reflected in elevated troponin levels is suggested. Any episode of chest tightness or pain following FUGS should be considered as possibly cardiac in origin. Sustained symptoms warrant admission to hospital for troponin monitoring and ECG assessment.

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A case report of dipyridamole stress-induced ST depression progressing to ST-elevation myocardial infarction despite intravenous aminophylline: steal, spasm, or something else?

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz054 ◽

2019 ◽

Vol 3 (2) ◽

Cited By ~ 1

Author(s):

Ki Fung Cliff Li ◽

Hee Hwa Ho ◽

Min Sen Yew

Keyword(s):

Myocardial Infarction ◽

Rare Complication ◽

Coronary Artery Occlusion ◽

Coronary Intervention ◽

Artery Occlusion ◽

St Elevation Myocardial Infarction ◽

St Depression ◽

St Elevation ◽

Coronary Steal ◽

Dipyridamole Stress

Abstract Background Dipyridamole stress is commonly used for myocardial perfusion imaging and is generally safe. Myocardial ischaemia can occasionally occur and is classically thought to be due to coronary steal as a result of redistribution of flow away from collateral dependent myocardium. Although ischaemia more commonly presents as electrocardiographic (ECG) ST depression and angina, ST-elevation myocardial infarction may occur as a very rare complication. Case summary We report a case of a patient who developed chest pain and ST depression during dipyridamole infusion. The pain persisted despite intravenous aminophylline with new inferior ST elevation soon after. Coronary angiography showed subtotal right coronary artery occlusion with no collateral supply. The symptoms and ECG changes resolved after percutaneous coronary intervention. Discussion Coronary steal may not fully account for our patient’s presentation given the failure of aminophylline and absent angiographic collaterals. Vasospasm may be triggered by dipyridamole and can directly cause ischaemia or provoke rupture of an unstable plaque. Augmentation of cardiac energetics during vasodilator stress may also play a role.

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