Coronary Artery Embolism

Etiology

• Direct: Clot (LV thrombus, LAA Thrombus), Valve (Vegetation, Thrombus, Fibroelastoma), Mass (Myxoma, Rhabdomyosarcoma)
• Paradoxical: Right to Left from Venous System/Right Heart, Via PFO or Interatrial Shunt
• Iatrogenic: s/p Coronary Angiography or Cardiac Surgery (Most Common Cause)

Scoring

• Major: Angiographic evidence without significant atherosclerosis, coronary emboli in multiple territories, systemic embolization without LV thrombus, venous origin on histology, embolic source on imaging.
• Minor: <25% stenosis in non-culprit vessels, atrial fibrillation, embolic risk factors (prosthetic valve, PFO, ASD, cardiac surgery history, endocarditis, hypercoagulable state).
• Scoring Criteria: Definite (≥2 Major) or (1 Major + ≥2 Minor) or (3 Minor); Probable (1 Major + 1 Minor) or (2 Minor).

Produced by: Dr. Thomas M. Das
Edited by: Dr. Karan Desai

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