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Recurrent myocardial infarction in a 47‐year‐old woman with a mechanical mitral valve prosthesis: Atherosclerosis, embolism, or spasm?
Author(s) -
Claessen Bimmer E.,
van den Boogert Thomas P. W.,
Piek Jan J.
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27186
Subject(s) - medicine , cardiology , myocardial infarction , etiology , embolism , mitral valve , embolization , infarction , electrocardiography , radiology
We present a case of a 47‐year‐old woman with a mechanical mitral valve prosthesis and recurrent myocardial infarction. The most common etiology of spontaneous myocardial infarction is an acute coronary syndrome caused by rupture or erosion of an atherosclerotic plaque. However, the differential diagnosis in the patient described below also included infarction due to embolization or coronary spasm. It can be challenging to discriminate between the different causes of myocardial infarction based on interpretation of symptoms, physical examination, laboratory tests, and electrocardiography alone. This report illustrates the value of coronary angiography with invasive coronary spasm provocation testing using intracoronary acetylcholine to identify the etiology of her recurrent myocardial infarctions.