Yeungnam Univ J Med.  2018 Dec;35(2):227-231. 10.12701/yujm.2018.35.2.227.

Acute left main coronary artery thrombosis as an initial presentation of systemic lupus erythematosus

• Choi KU
• Kim U

• KMID: 2433744
• DOI: http://doi.org/10.12701/yujm.2018.35.2.227

Abstract

Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.

Keyword

Coronary thrombosis; Systemic lupus erythematosus

MeSH Terms

Anemia, Hemolytic
Antibodies, Antinuclear
Chest Pain
Coronary Angiography
Coronary Thrombosis
Coronary Vessels*
Dyspnea
Electrocardiography
Emergencies
Humans
Lupus Erythematosus, Systemic*
Myocardial Infarction
Reperfusion
Steroids
Thrombosis*
Antibodies, Antinuclear
Steroids

Figure

• 

  Fig. 1. Initial electrocardiogram findings. There is normal sinus rhythm with ST elevation in leads I, aVL and V1-3, and ST segment depression in leads II, III and aVF.

• 

  Fig. 2. Initial coronary angiographic findings. (A) Ttotal occlusion of left main coronary artery trunk. (B, C) Procedure of aspiration of thrombus and huge red thrombus was aspirated. (D) After thrombus aspiration, TIMI 3 flow was obtained.

• 

  Fig. 3. Follow-up coronary angiographic findings at 1 year after index procedure (A-D). No luminal stenosis in left main coronary trunk (C) and there is good patency in right coronary artery stent (D).

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