Coronary embolism: A systematic review.

Title

Coronary embolism: A systematic review.

Creator

Lacey MJ; Raza S; Rehman H; Puri R; Bhatt DL; Kalra A

Publisher

Cardiovascular revascularization medicine : including molecular interventions

Date

2020
2020-03

Description

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.

Identifier

PMID: 31178350

Rights

Copyright © 2019 Elsevier Inc. All rights reserved.

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

367-374

Issue

3

Volume

21

ISSN

1878-0938 1878-0938

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Internal Medicine

Update Year & Number

June2020SubmittedList

Affiliated Hospital

Cleveland Clinic Akron General Hospital

Citation

Lacey MJ; Raza S; Rehman H; Puri R; Bhatt DL; Kalra A, “Coronary embolism: A systematic review.,” NEOMED Bibliography Database, accessed August 4, 2021, https://neomed.omeka.net/items/show/11179.

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