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A Peculiar Case of Recurrent Coronary Artery Thrombosis

Coronary artery thrombosis is a phenomenon physicians have studied throughout the years. The different risk factors that play a role in the formation of an atherosclerotic plaque leading to coronary artery blockage are vast and can affect the patient significantly if not examined and diagnosed caref...

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Autores principales: Nwaobi, Samuel, Wood, Zachary, Kalra, Aarushi, Nguyen, Sophia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584630/
https://www.ncbi.nlm.nih.gov/pubmed/36304350
http://dx.doi.org/10.7759/cureus.29357
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author Nwaobi, Samuel
Wood, Zachary
Kalra, Aarushi
Nguyen, Sophia
author_facet Nwaobi, Samuel
Wood, Zachary
Kalra, Aarushi
Nguyen, Sophia
author_sort Nwaobi, Samuel
collection PubMed
description Coronary artery thrombosis is a phenomenon physicians have studied throughout the years. The different risk factors that play a role in the formation of an atherosclerotic plaque leading to coronary artery blockage are vast and can affect the patient significantly if not examined and diagnosed carefully. The objective of this case report is to highlight this unusual occurrence of repeated coronary artery thrombosis. A 54-year-old Caucasian female presented to the emergency department with a one-day history of sharp chest pain in the substernal area that radiated between her shoulder blades and left arm. Despite being on dual antiplatelet therapy, an electrocardiogram (ECG) showed an inferior ST-elevation myocardial infarction (STEMI). Her medical history was extensive with factor V Leiden deficiency, hyperhomocysteinemia, recurrent deep vein thrombosis (DVT), and a family history of myocardial infarction. The patient was taken to the cardiac catheterization lab based on these characteristics. The patient was diagnosed with a 100% thrombosis in the distal right coronary artery (RCA), which was stented nine months before this current presentation. The patient had been compliant with all her medications from her previous stent placement. A new drug-eluting stent (DES) was inserted, and the patient was placed on prasugrel and apixaban. This was a very interesting topic for a case report due to the time frame of repeat thrombosis in a coronary artery with a DES and the patient’s underlying hypercoagulable state. There are few cases of same vessel restenosis post-DES placement. Our case highlights the need for further research into the prevalence of genetic risk factors in coronary artery thrombosis and the need to investigate the efficacy of different anticoagulation therapies in patients with factor V Leiden thrombophilia. 
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spelling pubmed-95846302022-10-26 A Peculiar Case of Recurrent Coronary Artery Thrombosis Nwaobi, Samuel Wood, Zachary Kalra, Aarushi Nguyen, Sophia Cureus Cardiology Coronary artery thrombosis is a phenomenon physicians have studied throughout the years. The different risk factors that play a role in the formation of an atherosclerotic plaque leading to coronary artery blockage are vast and can affect the patient significantly if not examined and diagnosed carefully. The objective of this case report is to highlight this unusual occurrence of repeated coronary artery thrombosis. A 54-year-old Caucasian female presented to the emergency department with a one-day history of sharp chest pain in the substernal area that radiated between her shoulder blades and left arm. Despite being on dual antiplatelet therapy, an electrocardiogram (ECG) showed an inferior ST-elevation myocardial infarction (STEMI). Her medical history was extensive with factor V Leiden deficiency, hyperhomocysteinemia, recurrent deep vein thrombosis (DVT), and a family history of myocardial infarction. The patient was taken to the cardiac catheterization lab based on these characteristics. The patient was diagnosed with a 100% thrombosis in the distal right coronary artery (RCA), which was stented nine months before this current presentation. The patient had been compliant with all her medications from her previous stent placement. A new drug-eluting stent (DES) was inserted, and the patient was placed on prasugrel and apixaban. This was a very interesting topic for a case report due to the time frame of repeat thrombosis in a coronary artery with a DES and the patient’s underlying hypercoagulable state. There are few cases of same vessel restenosis post-DES placement. Our case highlights the need for further research into the prevalence of genetic risk factors in coronary artery thrombosis and the need to investigate the efficacy of different anticoagulation therapies in patients with factor V Leiden thrombophilia.  Cureus 2022-09-20 /pmc/articles/PMC9584630/ /pubmed/36304350 http://dx.doi.org/10.7759/cureus.29357 Text en Copyright © 2022, Nwaobi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Nwaobi, Samuel
Wood, Zachary
Kalra, Aarushi
Nguyen, Sophia
A Peculiar Case of Recurrent Coronary Artery Thrombosis
title A Peculiar Case of Recurrent Coronary Artery Thrombosis
title_full A Peculiar Case of Recurrent Coronary Artery Thrombosis
title_fullStr A Peculiar Case of Recurrent Coronary Artery Thrombosis
title_full_unstemmed A Peculiar Case of Recurrent Coronary Artery Thrombosis
title_short A Peculiar Case of Recurrent Coronary Artery Thrombosis
title_sort peculiar case of recurrent coronary artery thrombosis
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584630/
https://www.ncbi.nlm.nih.gov/pubmed/36304350
http://dx.doi.org/10.7759/cureus.29357
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