Iranian Heart Journal

Iranian Heart Journal

A Case of Myocardial Infarction With Nonobstructive Coronary Arteries due to the Compressive Effects of a Type B Thymoma With Internal Hemorrhage

Document Type : Case Report

Authors
Rahimeh Eskandarian 1
Zahra Alizadeh Sani 2
Mohaddeseh Behjati 2
Roohallah Alizadehsani 3
Abbas Khosravi 3
Saeid Nahavandi 3
Sheikh Mohammed Shariful Islam 4
1 Internal Medicine Research Center, Semnan University of Medical Sciences, Semnan, IR Iran.
2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
3 Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, VIC 3216, Australia.
4 Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia.
Abstract
Our case was a 45-year-old woman who presented with a chief complaint of intermittent typical chest pain. In electrocardiography, ST-elevation in the lateral leads was observed. Echocardiography showed mild left ventricular systolic dysfunction with hypokinesia in the anteroapical segment. Coronary angiography was normal, and chest computed tomography showed a large mediastinal mass without any compression on the coronary arteries. Cardiac magnetic resonance imaging demonstrated a nonhomogeneous encapsulated mass close to the right ventricle and adjacent to the ascending aorta, the pulmonary artery trunk, and the superior vena cava, with compression effects on the coronary artery. There was transmural gadolinium enhancement in the mid-to-apical anterior and inferior walls with akinesia in these segments, in favor of myocardial infarction with nonobstructive coronary arteries. The patient underwent surgical mass resection, and the pathological investigation confirmed the diagnosis of a type B1 thymoma. (Iranian Heart Journal 2022; 23(1): 214-219)
Keywords
Myocardial infarction with nonobstructive coronary arteries
Coronary artery compression
Thymoma
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Iranian Heart Journal
Volume 23, Issue 1
Winter 2022
Pages 214-219