Clinical Case Database / Category: Patient Management
Myocardial infarction due to thrombosis of coronary artery aneurysm
Vidushi Golash, Dr Dwayne Conway
Foundation Years Journal, volume 7, issue 6, p.52 (123Doc Education, London, June 2013)
A 65-year-old male self-presented to the Accident and Emergency (A&E) department with severe sudden onset central chest pain. He was diagnosed with non-ST-elevation myocardial infarction (nSTEMI) which had occurred due to poor compliance with prescribed anticoagulation leading to thrombosis of a longstanding coronary artery aneurysm, rather than a coronary stenosis. This required some deviation from â€˜standardâ€™ nSTEMI management. Clinicians should tailor evidence-based guidelines to the individual circumstances of each patient, rather than adopting a â€˜one size fits allâ€™ attitude, and good communication between professionals and patients is key to optimal medical care.
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Third Year Medical Student
University Of Leeds
Dr Dwayne Conway (Corresponding author)
Consultant Interventional Cardiologist
Gate 47, Pinderfields Hospital
1. Cohen P, Oâ€™Gara PT. Coronary artery aneurysms: a review of the natural history, pathophysiology and management. Cardiology in Review 2008; 16: 301-304.
2. National Institute for Health and Clinical Excellence. Unstable angina and NSTEMI: The early management of unstable angina and non-ST-elevation myocardial infarction. Clinical Guideline 94. 2010. http://guidance.nice.org. uk/CG94
3. Hochman JS, Reynolds HR, DzavÃk V, et al; Occluded Artery Trial Investigators. Long-term effects of percutaneous coronary intervention of the totally occluded infarct-related artery in the subacute phase after myocardial infarction. Circulation 2011; 124: 2320-2328
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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