Introduction
ST-segment elevation myocardial infarction (STEMI) due to coronary artery occlusion caused by intracoronary trombosis in the setting of acute carbon monoxide (CO) poisoning is a very rare presentation. Here, a case of intracoronary large and mobile thrombus formation after CO poisoning is presented.
Case Presentation
A previously healthy 50-year-old woman was referred for CO poisoning. She had chest pain after the exposure to carbon monoxide. She was suffered from gas poisoning and her initial mental status was preoccupied with chest pain like such as weight. Her initial CO fraction was 28.1%, and initial laboratory data showed creatinine kinase-myocardial bound of 134 U/L (upper limit 25 U/L) and troponin I of >50 ng/mL (upper limit 0,06 ng/mL). Electrocardiography was taken on admission, revealing a ST segment elevation in the inferolateral leads. After initial evaluating, primary coronary angiography was performed and intracoronary large-mobile thrombus viewed in proximal left anterior descending artery(LAD) and no significant stenosis. We decided to give tenecteplase 10 mg with heparin. After the thrombolytic therapy, ST elevation in the inferolateral leads had resolved. Control angiography was performed after 24 h, thrombus in LAD had resolved. The patient was discharged home after 5 days, with persistent Q wave in inferior leads and mild hypokinesia of the inferoposterior wall suggesting myocardial injury.
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