Clinical image; Management of Coronary Artery Thrombosis

Acute myocardial infarction is an increasing cause of morbidity and mortality in the world. This condition sometimes happens as a result of coronary arteries blockage due to clot formation, spasm or plaque rupture.

Cases Report: A 31-year-old man referred to our hospital with severe exertional chest pain. Electrocardiogram revealed ST- segment elevation in precordial leads. Coronary arteries angiography revealed a visible clot at  proximal part of left anterior descending artery. As the thrombolysis in myocardial infarction (TIMI)  flow of the artery was  normal and the patient became  asymptomatic , conservative management was considered. The patient was commenced on anticoagulant, glycoprotein  2b/3a  inhibitor,  aspirin, and  clopidogrel. Follow-up  angiography  showed normal flow with no clot existence.

Coronary thrombus is an etiology of acute coronary syndrome. Patients often have varying levels of concurrent atherosclerosis. It’s management is anticoagulation, thrombolysis, and occasionally invasive strategies . Some cases can be managed conservatively, so decision-making is an import part of these patients management.