Acute myocardial infarction and left ventricular thrombus in a young male with thromboangiitis obliterans: a case report and literature review

Abstract

Thromboangiitis obliterans (TAO) is an inflammatory vascular disease that primarily affects the small- and medium-sized arteries of the extremities. Coronary artery involvement in TAO is rarely reported, and we present the first case of TAO involving the coronary arteries with concomitant left ventricular thrombus. In addition, our case report includes a literature review on coronary artery involvement in TAO and draws comparisons with systemic vasculitis with coronary artery involvement. The case report and literature review aims to offer physicians valuable insights for diagnosis and treatment of TAO with coronary arteries involvement, while also advocating for increased research efforts to explore therapeutic strategies for this rare condition, including both pharmacological treatment and interventional therapy.

Keywords: Acute myocardial infarction; Coronary artery; Literature review; Thromboangiitis obliterans; Young male smoker.

Fig. 1

Electrocardiogram. ST segment elevation in V1-V4 and frequent ventricular bigeminy

Fig. 2

Coronary angiography. Total occlusion of middle and distal segments of right coronary artery with the formation of multiple lateral branches (arrow, left). Angiography image of left coronary artery (right)

Fig. 3

The clinical manifestations of the patient’s digits

Fig. 4

Computed tomography angiography of lower limbs. Severe stenoses of left popliteal artery and left anterior tibial artery, and severe segmental stenoses in left peroneal artery and left posterior tibial artery (arrow)

Fig. 5

Thrombus in left ventricular apex. A left ventricular apical thrombus demonstrated by ultrasonic cardiogram (arrow, left) and cardiovascular magnetic resonance (arrow, right)