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.
Rights
Copyright © 2019 Elsevier Inc. All rights reserved.
Format
journalArticle
URL Address
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 April 26, 2024, https://neomed.omeka.net/items/show/11179.