Dissolution of a huge spontaneous coronary artery thrombus with a new antiplatelet agent and coronary angioplasty

A huge thrombus was observed in the proximal portion of the right coronary artery (RCA) in a 75-year-old patient. He presented with symptoms of cardiogenic shock due to acute myocardial infarction. Glycoprotein IIb/IIIa inhibitor (Tirofiban) was administered intra-coronary first, coronary angioplasty was performed later and, dramatic thrombus dissolution was observed on control coronary angiography.