TY  - BOOK
AU  - Santos, Ronald F., MD.
AU  - Cruz, Riza, MD.
AU  - Vicaldo, Efren, MD.
TI  - A Road less travelled: coronary thromboembolism in a patient with a prosthetic heart valve / 
AV  - MED20150005 
PY  - 2015///
CY  - Fairview, Quezon City
PB  - Department of Medicine, FEU-NRMF
N1  - Includes appendices and bibliographical references; RESDM
N2  - ABSTRACT: Prosthetic valve thromboembolism is an uncommon but severe complication in patients who have undergone valve replacement. This is most likely due to the increased thombogenicity brought about by poor adherence or insufficient anticoagulation. 1 We are presented with a case of 35 year old female with a history of rheumatic fever, and had undergone aortic valve replacement and maintained on oral anticoagulation, who presented at the ER with a sudden onset of chest pain. Upon consult at the ER, ECG as well as Troponin  I were requested. ECG showed sinus rhytm, left axis deviation, left atrial abnormality, poor R wave progression diffuse ischemia and probable old inferior wall infarction.  Troponin I was elevated at 42,452 U/L .Angiogram was done which showed an occlusion of the left anterior descending artery. The patient was managed as a case of non-ST elevation myocardial infarction caused by an emboli from the mechanical aortic valve, and was treated by anticoagulation and thrombolysis using streptokinase and heparin
ER  -