Coronary Emboli in a Young Patient with Mechanical Aortic Valve: A Rare Cause of Acute Myocardial Infarction

Abstract: Coronary artery embolism is an uncommon cause of Acute Myocardial Infarction (AMI). Herein, we reported a 24-year-old male who was admitted with acute infero-posterior myocardial infarction and cerebral Transient Ischemic Attack (TIA). He had undergone mechanical Aortic Valve Replacement (AVR) surgery 6 years ago. Surprisingly, the patient had decided to stop taking his medication (warfarin) 20 days earlier without any medical advice. Coronary angiography revealed a thrombus located at the distal part of the left circumflex artery. Discontinuation of anticoagulant therapy in the presence of mechanical valve prosthesis, clinical evidence of coincidental TIA, and lack of atherosclerotic risk factors were highly suggestive of coronary thromboembolism as the cause of AMI. Overall, this case report emphasized the necessity of continuous education in patients with mechanical heart valves to prevent such undesired events.