This report describes a case of coronary embolism with ST segment elevation in a patient with aortic and mitral valve replacement admitted to our emergency department with complaining chest pain. A 25- year- old male was admitted to our emergency department complaining chest pain. The patient's chest pain was sudden, onset and compressive style. In his medical history he had aortic and mitral valve replacement two years ago. He was using warfarin regularly. His physical examination was normal. The ECG showed ST segment elevation in leads II, III and aVF. In laboratory analysis, creatine kinase MB (CK-MB) was 159 U/L (upper limit 25 U/L), troponin-I was 6.8 ng/ml (upper limit 0.01 ng/ml) and CK was 1225 U/L (upper limit 170 U/L). International normalized ratio (INR) was 1.2 although the patient was receiving warfarin treatment. Medical treatment was started in the emergency department immediately and cardiology consultation was requested. Coronary angiography was made to the patient by cardiologist. The patient's coronary angiography showed thrombus which caused %99 occlusion of circumflex artery (Cx) after OM2 branch. Thrombus aspiration was performed and treatment was contiuned at coronary intensive care unit. In his follow-up examination ECG changes was occurred. The patient's ECG showed normal sinus rhythm. In his following blood tests; troponin-I, CK and CK-MB decreased normal levels. After warfarin dosage adjustment the INR increased to 3.7. The patient continued to improve clinically and was discharged home. Coronary embolism should be suspected in patients with complaining chest pain, medical history of valve replacement and ST segment elevation.
Key words: Coronary Embolism; St Segment Elevation; Chest Pain.
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