영구적 심방세동 환자에서 동시 발병한 급성 ST 분절 상승 심근경색과 다발성 말초 및 전신동맥 색전증

Synchronous acute ST segment elevation myocardial infarction and multiple peripheral or systemic arterial embolism in a patient with permanent atrial fibrillation

Acute myocardial infarction(AMI) is myocardial necrosis resulting from acute obstruction of a coronary artery, which is a significant cause of morbidity and mortality among adults worldwide. Coronary artery plaque rupture, erosion, thrombosis, and dissection account for nearly all obstruction of a coronary artery. However, coronary artery embolism is also one of the rare but important causes of AMI. It is imperative that practicing clinicians be aware of coronary embolism as a cause of AMI, particularly in high-risk populations such as those with atrial fibrillation. Atrial fibrillation(AF) is one of the most common dysrhythmias, in general, the most concerning complication of AF is thromboembolic events including cardioembolic stroke and systemic embolism. For many patients with AF, anticoagulation therapy is the cornerstone of management to prevent thromboembolic events. Here, we report a very rare case of not only acute ST segment elevation myocardial infarction(STEMI) due to coronary artery embolism but also several systemic embolic events(SEE) including acute unilateral renal infarction and the sudden occlusion of the superior mesenteric artery and right popliteal artery caused by multiple peripheral or systemic arterial embolism simultaneously developed in a 77-year-old man with permanent atrial fibrillation after discontinuing anticoagulation arbitrarily.