Coronary Thrombosis and Myocardial Bridging
A 28-year-old man presented with heavy chest pain that had lasted for 4 hours. Previously, he had been healthy, and he had no risk factors for coronary artery disease. Physical examination was unremarkable. The ECG showed an anterior myocardial infarction. Recombinant tissue plasminogen activator, heparin, and aspirin were administered, and the patient was referred to our center for emergency coronary angiography. A large intraluminal filling defect was observed in the left anterior descending artery (LAD) (Figures 1A and 1B), which was suggestive of an extensive intracoronary thrombus. Other coronary arteries appeared normal. The patient received abciximab therapy for 24 hours and enoxaparin for 10 days; he was then discharged on aspirin (160 mg daily) and clopidogrel (75 mg daily).
At 3 months, the patient was asymptomatic; systematic control angiography showed complete disappearance of the thrombus (Figures 1C and 1D), with no residual stenosis. The LAD was widely patent, with a typical image of myocardial bridging (Figure 2).