Coronary embolism causing myocardial infarction after heart valve surgery

Abstract

Introduction. Coronary embolism can rarely be a cause of myocardial infarction. It is usually associated with atrial fibrillation, dilated cardiomyopathy, bacterial endocarditis and underlying hypercoagulable state, as well as heart surgery. Case report. We reported a case of a patient with severe mitral and tricuspid regurgitation, with no underlying coronary artery disease. The patient underwent heart valve surgery, and the immediate postoperative course was uneventful. Five days after the operation, the patient sustained cardiac arrest, which was followed by a successful cardiopulmonary resuscitation. Electrocardiography showed atrial fibrillation with a significant ST segment elevation in the inferior leads. Urgent coronary angiography revealed a total occlusion of the right coronary artery, thus percutaneous coronary intervention was performed, after which flow restoration through the artery was achieved. The patient was discharged with triple antithrombotic therapy on the 20th postoperative day. Conclusion. Heart surgery could be followed by unexpected and potentially fatal complications, coronary embolism being one of them. In such case, the prompt and adequate reaction by the whole medical team is crucial for a patient's survival and recovery.