Complexity of clinical status and therapeutic difficulties in 85-year-old patient with atrial fibrillation

Abstract

We present a case of 85-year-old patient diagnosed with ST-segment elevation myocardial infarction of anterior wall due to coronary embolism secondary to persistent atrial fibrillation. The patient was performed coronary angiography and aspiration thrombectomy. Due to lack of atherosclerotic lesions, there was no need of stent implantation. On echocardiography we found left atrium appendage thrombus. After she was given dual antiplatelet therapy and rivaroxaban, gastrointestinal bleeding was observed. After that incident rivaroxaban was discontinued, which has led to the right axillary artery embolism. Afterwords she was given therapy only with oral anticoagulant and qualified to left atrium appendage closure.