Categorising myocardial infarction with advanced cardiovascular imaging
Evangelos Tzolos, Rong Bing, David E. Newby, Marc R. Dweck
Abstract
A 66-year-old man collapsed at home with chest pain. He was found by paramedics to be in ventricular fibrillation leading to a cardiac arrest. A post-resuscitation electrocardiogram showed sinus rhythm and inferolateral ST-segment elevation. On arrival at our department he had an emergency invasive coronary angiogram which showed an occluded left circumflex artery, confirming myocardial infarction (MI). We opened the artery using a balloon, and following recanalisation, we identified a substantial filling defect indicative of a large thrombus (figure). Following stent implantation, normal coronary artery flow was restored and the patient made an uneventful recovery—although brief paroxysms of atrial fibrillation were noted on cardiac monitoring in the ensuing 24 h.