ST-Segment Elevation Myocardial Infarction From Carney Complex Familial Myxoma Embolization

卡尼综合征家族性黏液瘤栓塞引起的ST段抬高型心肌梗死

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Abstract

BACKGROUND: Carney complex (CNC) is a rare condition associated with multiorgan system tumors. Cardiac myxomas are a frequent complication of this disease. CASE SUMMARY: A 20-year old man with CNC presented with 3 days of dyspnea. Echocardiography revealed a rapidly growing left atrial myxoma. He developed chest pain (score: 10/10) during his hospitalization and was found to have an acute inferior ST-segment elevation myocardial infarction (STEMI). Emergent percutaneous balloon angioplasty and aspiration thrombectomy were performed, with eventual surgical myxoma excision. DISCUSSION: STEMI due to myxoma embolization is rare and poorly understood. This case highlights the pathophysiology and complications associated with CNC, the acute therapeutic interventions for STEMI from myxoma embolization, and the long-term management of atrial myxomas. TAKE-HOME MESSAGES: In young patients with CNC, STEMI is often embolic from cardiac myxomas; acute treatment typically involves percutaneous coronary intervention with thrombectomy rather than stent placement. Definitive treatment involves surgical excision of the myxoma using a multidisciplinary approach, although recurrence rates are high in CNC.

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