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June 2020 Vol. 8 No.6

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Krastev PK
Manov EI

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Merit Research Journal of Medicine and Medical Sciences (ISSN: 2354-323X) Vol. 8(6) pp. 279-283, June, 2020 

Copyright © 2020 Merit Research Journals
DOI: 10.5281/zenodo.3908634

Case Report

A case of acute myocardial infarction without coronary artery disease: what else could it be?


Plamen K. Krastev1, Stefan N. Naydenov2 and Emil I. Manov3


1Assistant professor at UMBAL “St. Ekaterina”, Medical University of Sofia, Bulgaria
2Associate professor at the Department of Internal Diseases “Prof. St. Kirkovich”, Medical University of Sofia, Bulgaria
3Associate professor at the Department of Internal Diseases “Prof. St. Kirkovich”, Medical University of Sofia, Bulgaria

*Corresponding Author's E-mail: snaydenov@gmail.com
Mobile: +359 888 52 84 17
Fax: +359 2 92 30 658

Received: 06 June 2020  I  Accepted: 24 June 2020  I  Published: 28 June 2020  I  Article ID: MRJMMS-20-094
Copyright © 2020 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0.




Coronary embolism of non-cardiac origin is a rare cause for acute myocardial infarction. A 93-year-old female patient was admitted to our hospital for acute chest pain, persistent ST-segment elevation in the inferior electrocardiographic leads and elevated troponin T. The emergency coronary angiography showed total occlusion of the postero-lateral branch of the right coronary artery. Thrombaspiration was performed and coronary blood flow was completely restored. Surprisingly, the evacuated material was not thrombotic; the histologic analysis revealed metastatic embolus from an adenocarcinoma. The subsequent computed tomography of the chest and the additional investigations confirmed the primary source of the coronary embolism: lung adenocarcinoma. Coronary embolism due to a metastatic lung cancer is a rare, but possible cause for acute myocardial infarction. Thrombaspiration is a successful method for treatment of the acute coronary occlusion and provides material for identifying the primary source of the emboli.

Keywords: Adenocarcinoma, Coronary, Embolism, Metastasis, Thrombaspiration










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