Large Coronary Arteries Mean No Chance of a Heart Attack, Right? An Acute Myocardial Infarction in the Setting of Holding Anticoagulation for a Routine Colonoscopy

Coronary artery ectasia (CAE) is an uncommon pathology, which is sometimes incidentally found on left heart catheterization (LHC). CAE is occasionally treated with systemic anticoagulation to prevent thrombosis or progression of the clot in the coronary arteries. We present a 63-year-old male with known CAE on warfarin who presented to the hospital with myocardial infarction after a routine colonoscopy for which anticoagulation was held. His myocardial infarction was attributed to a likely coronary thromboembolic event. This case highlights the need for consideration of bridging anticoagulation therapy before and after procedures in patients with CAE to prevent adverse coronary events.