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Case Reports

Subclavian Artery Thrombosis Associated With Acute ST-Segment Elevation Myocardial Infarction

^a Division of Cardiology, Department of Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan
^b Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
^c Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
^d Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
^e School of Medicine, National Yang-Ming University, Taipei, Taiwan

Accepted for publication May 14, 2009.

^_* Address correspondence to Dr Wu, Division of Cardiology, Department of Medicine, Taipei Medical University-Shuang Ho Hospital, No. 291, Zhong-Zheng Rd, Jhonghe City, 235, Taipei, Taiwan (Email: chwu6{at}vghtpe.gov.tw).

Presentation of acute ST segment elevation myocardial infarction in the setting of acute subclavian artery thrombosis in a patient who underwent coronary artery bypass grafting with a left internal mammary artery graft, which is not believed to have been previously described. We report a 75-year-old woman with presentations of dizziness, nausea, left-arm numbness, and a cold left hand, who later had chest pain develop. Acute ST segment elevation myocardial infarction was diagnosed, and both a computed tomography and an angiography disclosed a thrombus extending from the proximal portion of the left subclavian artery to the orifice of the left internal mammary artery. The patient was free from the previously listed symptoms after undergoing emergent thrombectomy, with complete extraction of the long thrombus from the subclavian artery. Unfortunately, she died of pneumonia and septic shock 1¹/₂ months later.