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Case Reports
. 2024 Dec 28;2024(12):omae163.
doi: 10.1093/omcr/omae163. eCollection 2024 Dec.

Paradoxical coronary embolism in Erdheim-Chester disease: invasive assessment and multidisciplinary management

Vasileios Lamprou  1 , Matthew J Daniels  1 , Charles D Read  1 , Freidoon Keshavarzi  1   2
Affiliations
Case Reports

Paradoxical coronary embolism in Erdheim-Chester disease: invasive assessment and multidisciplinary management

Vasileios Lamprou et al. Oxf Med Case Reports. .

Abstract

We report a case of non-ST elevation myocardial infarction in a 36-year-old man with Erdheim-Chester disease (ECD). Multimodality assessment revealed acute coronary thrombus with simultaneous recurrent pulmonary embolism in spite of compliance with a direct oral anticoagulant. Prior case reports of acute myocardial infarction in this population have not outlined the role of catheter based intravascular assessment and treatment in this rare clinical entity.

Keywords: Erdheim-Chester disease; coronary embolism; non-ST elevation myocardial infarction.

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Conflict of interest statement

No conflict of interest.

Figures

Figure 1
Figure 1
Computerized tomography (CT) coronary angiogram. 15 mm non-calcified lesion from ostial to proximal left anterior descending (LAD) coronary artery causing moderate to severe stenosis.
Figure 2
Figure 2
Initial angiogram. Ostial filling defect in the left anterior descending (LAD) coronary artery (arrow).
Figure 3
Figure 3
Repeat angiogram. Improvement to previous ostial left anterior descending (LAD) coronary artery lesion.
Figure 4
Figure 4
Intravascular ultrasound (IVUS). Features of thrombus (arrow).
Figure 5
Figure 5
PFO closure. A 25 mm amplatzer PFO occluder using a 8-French Trevision delivery system was used.
Figure 6
Figure 6
Repeat intravascular ultrasound (IVUS). Eccentric fatty/fibrotic plaque in proximal left anterior descending (LAD) coronary artery with mild calcification.
Figure 7
Figure 7
Repeat optical coherence tomography (OCT). Limited by dropout segment in proximal left anterior descending (LAD) coronary artery.
See this image and copyright information in PMC

References

    1. Goyal G, Heaney ML, Collin M. et al. . Erdheim-Chester disease: consensus recommendations for evaluation, diagnosis, and treatment in the molecular era. Blood 2020;135:1929–45. 10.1182/blood.2019003507. - DOI - PubMed
    1. Azoulay LD, Bravetti M, Cohen-Aubart F. et al. . Prevalence, patterns and outcomes of cardiac involvement in Erdheim-Chester disease. Eur Heart J 2023;44:2376–85. 10.1093/eurheartj/ehac741. - DOI - PubMed
    1. Brun AL, Touitou-Gottenberg D, Haroche J. et al. . Erdheim-Chester disease: CT findings of thoracic involvement. Eur Radiol 2010;20:2579–87. 10.1007/s00330-010-1830-7. - DOI - PubMed
    1. Haroche J, Amoura Z, Dion E. et al. . Cardiovascular involvement, an overlooked feature of Erdheim-Chester disease: report of 6 new cases and a literature review. Medicine (Baltimore) 2004;83:371–92. 10.1097/01.md.0000145368.17934.91. - DOI - PubMed
    1. Alharthi MS, Calleja A, Panse P. et al. . Multimodality imaging showing complete cardiovascular involvement by Erdheim-Chester disease. Eur J Echocardiogr 2010;11:E25–5. 10.1093/ejechocard/jeq052. - DOI - PubMed

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