Small Septal Branch Artery Thrombus Inducing Ventricular Fibrillation: To Intervene or Not to Intervene

Clinical Medicine Insights. Case Reports
Vratika AgarwalJames Lafferty

Abstract

A 64-year-old woman presented for chest pain and was diagnosed with anteroseptal ST segment elevation myocardial infarction (STEMI). Emergent angiography showed 95% stenosis at the ostium of the second septal branch, consistent with thrombus, and no other significant lesions. The lesion was not amenable to intervention due to small caliber. Post angiography, the patient's electrical rhythm deteriorated into ventricular fibrillation. Following resuscitation, repeat angiography confirmed same findings. Electrophysiology study at 3 months was positive for inducing fibrillation. Due to patient risk factors, she had placement of a dual chamber defibrillator. A 5-month follow-up echocardiogram showed a small area of ventricular septal wall bowing, consistent with blood supply from septal territory.

References

Jan 1, 1991·Catheterization and Cardiovascular Diagnosis·O TopazM J Cowley
Mar 1, 1993·American Heart Journal·D N VemuriV S Banka
May 29, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·I D CohenT Feldman
Sep 13, 2011·Journal of Electrocardiology·Janos TomcsanyiTamas Simor

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Methods Mentioned

BETA
coronary artery bypass

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