A 61-year-old Chinese female was admitted to the emergency department, presenting with severe chest pain and left upper limb swelling that had persisted for 2 h. Six years prior to admission, the patient was diagnosed with paroxysmal atrial flutter. Electrocardiography showed sinus rhythm, ST-segment level elevation on leads V1–V3. An emergency coronary angiography was performed. Left coronary angiography demonstrated ‘cutoff’ of the middle ends of the left anterior descending coronary artery (LAD) (Fig. 1): the left main, circumflex and right coronary arteries were normal. Thrombus aspiration was performed using an Export aspiration catheter in the LAD. Thrombi were aspirated and LAD was recanalized. There was no plaque rupture found in LAD by intravascular ultrasound (Fig. 2). So no coronary stent was implanted. After admission, ECG showed atrial flutter and abnormal Q wave in the anterior leads (V1–V4). Presumably, the patient’s atrial flutter was the underlying cause for the embolic event.
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