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Coronary artery thromboembolism from left appendage mural thrombus- a rare complication from atrial fibrillation

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Abstract

A 54-year-old man with recurrent, persistent atrial fibrillation was found dead unexpectedly. He was reportedly non-compliant with his medications and was not on anti-coagulant therapy. He was found dead in his residence after complaining of abdominal discomfort a day prior to death. Postmortem examination revealed a thromboembolus occluding the left anterior descending coronary artery that originated from a mural thrombus in the left appendage, in addition to kidney infarcts. Although atrial fibrillation-related thromboembolism is often speculated to be a cause of myocardial infarction with non-obstructive coronary arteries, supporting pathological evidence is rare. This case documents radiological, macroscopic and microscopic images of this important complication from atrial fibrillation.

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Authors and Affiliations

  1. Northern Forensic Pathology Service of New Zealand, Auckland, New Zealand

    Sinead McCarthy & Rexson Tse

  2. NSW Health Pathology, Forensic and Analytical Science Service, Sydney, New South Wales, Australia

    Jack Garland

  3. Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia

    Christopher X. Wong

  4. Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand

    Rexson Tse

Authors
  1. Sinead McCarthy
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  2. Jack Garland
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  3. Christopher X. Wong
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  4. Rexson Tse
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Correspondence to Rexson Tse.

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McCarthy, S., Garland, J., Wong, C.X. et al. Coronary artery thromboembolism from left appendage mural thrombus- a rare complication from atrial fibrillation. Forensic Sci Med Pathol 17, 522–525 (2021). https://doi.org/10.1007/s12024-021-00372-2

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  • DOI: https://doi.org/10.1007/s12024-021-00372-2

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