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Text
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<a href="http://doi.org/10.1016/j.carrev.2019.05.012" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.carrev.2019.05.012</a>
Pages
367-374
Issue
3
Volume
21
ISSN
1878-0938 1878-0938
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<a href="http://neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.carrev.2019.05.012" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.carrev.2019.05.012</a>
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Update Year & Number
June2020SubmittedList
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Internal Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
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Title
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Coronary embolism: A systematic review.
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Cardiovascular revascularization medicine : including molecular interventions
Date
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2020
2020-03
Creator
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Lacey MJ; Raza S; Rehman H; Puri R; Bhatt DL; Kalra A
Description
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BACKGROUND: Coronary embolism is a rare and potentially fatal phenomenon that occurs primarily in patients with valvular heart disease and atrial fibrillation. There is a lack of consensus regarding the diagnosis, treatment, and management of coronary embolism, leaving management at the discretion of the treating physician. Through this review, we aim to establish a better understanding of coronary embolism, and to identify treatment options - invasive and non-invasive - that may be used to manage coronary embolism. METHODS AND RESULTS: Our systematic review included 147 documented cases of coronary embolism from case reports and case series. The average age of our population was 54.2 ± 17.6 years. The most common causes of coronary embolism included infective endocarditis (22.4%), atrial fibrillation (17.0%), and prosthetic heart valve thrombosis (16.3%). Initial presentation was indistinguishable from an acute coronary syndrome (ACS) due to coronary atherosclerosis, and the diagnosis required a high level of suspicion and evaluation with angiography. Treatment strategies included, but were not limited to, thrombectomy, thrombolysis, balloon angioplasty and stent placement. Myocardial dysfunction on echocardiography was observed in over 80% of patients following coronary embolism. "Good outcomes" were reported in 68.7% of case reports and case series, with a mortality rate of 12.9%. CONCLUSION: Coronary embolism is an under-recognized etiology of myocardial infarction with the potential for significant morbidity and mortality. To improve outcomes, physicians should strive for early diagnosis and intervention based on the underlying etiology. Thrombectomy may be considered with the goal of rapid restoration of coronary flow.
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<a href="http://doi.org/10.1016/j.carrev.2019.05.012" target="_blank" rel="noreferrer noopener">10.1016/j.carrev.2019.05.012</a>
PMID: 31178350
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Copyright © 2019 Elsevier Inc. All rights reserved.
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journalArticle
2020
Bhatt DL
Cardiovascular revascularization medicine : including molecular interventions
Cleveland Clinic Akron General Hospital
Department of Internal Medicine
journalArticle
June2020SubmittedList
Kalra A
Lacey MJ
NEOMED College of Medicine
Puri R
Raza S
Rehman H