Case Report

Acute In-Stent Coronary Thrombosis Without ST Change on Electrocardiography: A Case Report and Literature Review

Authors: Chung-Ming Tu, MD, Kai-Ming Chu, MD, PhD, Cheng-Chung Cheng, MD, Chih-Lu Han, MD, PhD, Jun-Ting Liou, MD

Abstract

Coronary stent thrombosis is a major complication which occurs in 0.5-1.9% of patients undergoing stent implantation. The case of a 65-year-old male who was admitted to the hospital due to chest pain is presented. A 12-lead electrocardiography showed complete AV block, acute inferior wall, and right ventricle myocardial infarction. Coronary angiography showed total occlusion of the right coronary artery. Successful stent implantation was performed with optimal angiographic result. However, the patient developed chest discomfort and 12-lead electrocardiography showed no ST change. Coronary angiography revealed acute in-stent thrombosis. Another stent implantation was done with optimal angiographic result. Although rarely reported, acute in-stent thrombosis can be life-threatening, especially in cases where there is no ST change. For this reason, careful history taking and prompt coronary angiography may be life-saving.

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