{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:25Z","timestamp":1753876285878,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T00:00:00Z","timestamp":1628985600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Left main coronary artery (LMCA)\u2013acute coronary syndrome (ACS) is a rare complication of a floating thrombus in the ascending aorta. However, diagnosing the aetiology of LMCA\u2013ACS during an emergency situation is challenging. We present a rare case of LMCA\u2013ACS caused by a large thrombus in the ascending aorta, confirmed by intravascular ultrasound (IVUS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 90-year-old woman presented to the emergency department complaining of chest pain and syncope. On admission, her electrocardiogram showed normal sinus rhythm and a complete right bundle branch block with significant ST depression in the V3\u2013V6 leads; hence, ACS was suspected. The first emergency angiogram of the left coronary artery showed filling defect in the proximal ascending aorta. IVUS revealed a large thrombus in the ascending aorta. The thrombus extended from the ascending aorta to the proximal left anterior descending coronary artery. IVUS confirmed that there was no dissection of the coronary artery or the proximal ascending aorta. Based on the IVUS findings, this case was diagnosed as ACS of the LMCA caused by a floating thrombus in the ascending aorta.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This rare case of LMCA\u2013ACS caused by a thrombus in the ascending aorta was confirmed by IVUS, which can be a useful imaging tool for diagnosing morphological abnormalities during emergencies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab279","type":"journal-article","created":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T18:31:12Z","timestamp":1629052272000},"source":"Crossref","is-referenced-by-count":1,"title":["Acute coronary syndrome of the left main coronary artery caused by a huge floating thrombus in the ascending aorta: a case report of intravascular ultrasound effectiveness"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3448-0992","authenticated-orcid":false,"given":"Hiroya","family":"Takafuji","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba 279-0001, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9107-6438","authenticated-orcid":false,"given":"Tatsuya","family":"Nakama","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba 279-0001, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba 279-0001, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-6732","authenticated-orcid":false,"given":"Kotaro","family":"Obunai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba 279-0001, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,15]]},"reference":[{"key":"2021081518310503300_ytab279-B1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S1010-7940(00)00600-X","article-title":"Catastrophic consequences of a free floating thrombus in ascending aorta","volume":"19","author":"Bruno","year":"2001","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021081518310503300_ytab279-B2","first-page":"272","article-title":"Floating thrombus arising from left sinus of Valsalva induced intermittent occlusion of left coronary artery and caused cardiac shock","volume":"114","author":"Yamawaki","year":"2007","journal-title":"In J Cardiol"},{"key":"2021081518310503300_ytab279-B3","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1016\/j.jccase.2013.04.003","article-title":"Acute myocardial infarction caused by a floating thrombus in the ascending aorta: a role of CD34-positive endothelial cells","volume":"8","author":"Nishizaki","year":"2013","journal-title":"J Cardiol Cases"},{"key":"2021081518310503300_ytab279-B4","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s11748-015-0619-7","article-title":"A floating thrombus in the ascending aorta complicated by acute myocardial infarction","volume":"65","author":"Ozaki","year":"2017","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2021081518310503300_ytab279-B5","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.ijcard.2014.03.065","article-title":"IVUS images of the left main intramural hematoma from aortic dissection","volume":"173","author":"Kim","year":"2014","journal-title":"Int J Cardiol"},{"key":"2021081518310503300_ytab279-B6","doi-asserted-by":"crossref","first-page":"e133","DOI":"10.1016\/j.jccase.2012.02.004","article-title":"The usefulness of an intravascular ultrasound in the diagnosis of left main coronary artery dissection","volume":"5","author":"Arao","year":"2012","journal-title":"J Cardiol Cases"},{"key":"2021081518310503300_ytab279-B7","first-page":"421","article-title":"Left main coronary thrombotic occlusion due to secondary polycythemia in a normal sinus of Valsalva","volume":"25","author":"Kobayashi","year":"2013","journal-title":"J Invasive Cardiol"},{"key":"2021081518310503300_ytab279-B8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.echo.2003.10.002","article-title":"Acute myocardial infarction caused by embolism of thrombus in the right coronary sinus of Valsalva: a case report and review of the literature","volume":"17","author":"Eguchi","year":"2004","journal-title":"J Am Soc Echocardiogr"},{"key":"2021081518310503300_ytab279-B9","first-page":"660","article-title":"Successful treatment in a case of acute aortic dissection complicated with acute myocardial infarction due to occlusion of the left main coronary artery","volume":"15","author":"Ohara","year":"2003","journal-title":"J Invasive Cardiol"},{"key":"2021081518310503300_ytab279-B10","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/0002-9343(89)90454-3","article-title":"Aortic degenerative changes and thrombus formation: an unusual cause of massive myocardial infarction with normal coronary arteries","volume":"86","author":"Nader","year":"1989","journal-title":"Am J Med"},{"key":"2021081518310503300_ytab279-B11","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/j.jtcvs.2016.03.078","article-title":"Management of floating thrombus in the aortic arch","volume":"152","author":"Weiss","year":"2016","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/8\/ytab279\/39741678\/ytab279.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/8\/ytab279\/39741678\/ytab279.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T18:31:24Z","timestamp":1629052284000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab279\/6352636"}},"subtitle":[],"editor":[{"given":"Julien","family":"Adjedj","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Sherif Mohammad Abd","family":"ElSamad","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Al-Hijji","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Max","family":"Sayers","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mariame","family":"Chakir","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,1]]},"references-count":11,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab279","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2021,8,1]]},"published":{"date-parts":[[2021,8,1]]},"article-number":"ytab279"}}