Laoufi Zaynab^1,, Lokman Hafsa¹, Benyass Aatif¹, Mouine Najat¹, Lakhal Zouhair¹

Coronary embolism is a non-atherosclerotic cause of acute coronary syndromes. It is frequently observed in patients with atrial fibrillation or prosthetic heart valves. We report the case of a 40-year-old woman with no cardiovascular risk factors but a history of mechanical mitral valve replacement, who had discontinued her vitamin K antagonist (VKA) therapy without medical supervision. She presented with sudden-onset, typical anginal chest pain at rest, described as retrosternal pressure radiating to the left arm and associated with dyspnea. Transthoracic echocardiography revealed an abnormality on the mitral prosthesis, and transesophageal echocardiography confirmed the presence of a thrombus. Coronary angiography identified a subocclusive thrombotic lesion in the mid-left anterior descending (LAD) artery, consistent with coronary embolism. The patient underwent successful manual thrombectomy without stent implantation.

Coronary embolism, Prosthetic heart valve, Thrombectomy, Valve thrombosis