{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T06:41:59Z","timestamp":1777272119529,"version":"3.51.4"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coronary embolism is an uncommon cause of acute myocardial infarction, often related to atrial fibrillation or valvular heart disease. In such cases, concomitant valvular thrombosis requires additional diagnostic work-up and has major implications for subsequent management. Both conditions may represent significant diagnostic and therapeutic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report the case of a 71-year-old woman with double mechanical valve prostheses (aortic and mitral) under suboptimal anticoagulation therapy, who presented with chest pain and syncope. Initial workup revealed severe right ventricular dysfunction and dilation, with inconclusive electrocardiogram findings; pulmonary embolism was initially suspected. Emergent coronary angiography revealed a coronary embolism, successfully treated with thromboaspiration alone. The diagnosis of prosthetic valve thrombosis was delayed due to low cardiac output masking prosthetic dysfunction. Management of the valve thrombosis was unconventional, as therapeutic options were limited by a recent traumatic brain injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates the diagnostic and therapeutic challenges in patients with mechanical valve prostheses and high embolic risk. Atypical presentation and low-output conditions limited early identification of prosthetic valve thrombosis, highlighting the reduced sensitivity of transthoracic echocardiography in this context. Advanced imaging modalities, such as transoesophageal echocardiography or computed tomography, may improve diagnostic accuracy. Given absolute contraindications to both thrombolysis and surgery, the patient was managed with intensified anticoagulation, showing favourable clinical and echocardiographic evolution. This case emphasizes the need for individualized, context-driven decision-making in complex cardiovascular scenarios.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag070","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T12:43:39Z","timestamp":1772196219000},"source":"Crossref","is-referenced-by-count":0,"title":["From valve prosthesis to coronary artery: a fatal thrombus: a case report"],"prefix":"10.1093","volume":"10","author":[{"given":"Carlos","family":"Cobo-Lopez","sequence":"first","affiliation":[{"name":"Cardiology Unit, University Hospital Virgen Macarena , Avda Doctor Fedriani, 3, 41009 Sevilla ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3720-5941","authenticated-orcid":false,"given":"Gloria Rocio","family":"Padilla-Rodriguez","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University Hospital Virgen Macarena , Avda Doctor Fedriani, 3, 41009 Sevilla ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Gomez-Gonzalez","sequence":"additional","affiliation":[{"name":"Acute Cardiovascular Care Unit, University Hospital of the Canary Islands , Carretera Ofra S\/N, Carr. Gral. la Cuesta, 79, 38320 La Laguna, Santa Cruz de Tenerife ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Cortes-Cortes","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University Hospital Virgen Macarena , Avda Doctor Fedriani, 3, 41009 Sevilla ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Almendro-Delia","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University Hospital Virgen Macarena , Avda Doctor Fedriani, 3, 41009 Sevilla ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"2026042701465932700_ytag070-B1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1161\/CIRCULATIONAHA.114.015134","article-title":"Coronary artery embolism as a cause of acute myocardial infarction","volume":"132","author":"Shibata","year":"2015","journal-title":"Circulation"},{"key":"2026042701465932700_ytag070-B2","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.jcmg.2015.08.013","article-title":"Clinical impact of OCT findings during PCI: the CLI-OPCI II study","volume":"8","author":"Prati","year":"2015","journal-title":"JACC Cardiovasc Interv"},{"key":"2026042701465932700_ytag070-B3","doi-asserted-by":"crossref","first-page":"ytab115","DOI":"10.1093\/ehjcr\/ytab115","article-title":"Coronary embolism due to possible thrombosis of prosthetic aortic valve \u2012 the role of optical coherence tomography: case report","volume":"5","author":"Kavaliauskaite","year":"2021","journal-title":"Eur Heart J Case Rep"},{"key":"2026042701465932700_ytag070-B4","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab885","article-title":"2021 ESC guidelines for the management of valvular heart disease","volume":"43","author":"Baumgartner","year":"2022","journal-title":"Eur Heart J"},{"key":"2026042701465932700_ytag070-B5","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1016\/j.jacc.2020.11.018","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the ACC\/AHA Joint Committee on Clinical Practice Guidelines","volume":"77","author":"Otto","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026042701465932700_ytag070-B6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.jcmg.2012.10.016","article-title":"Comparison of different TEE-guided thrombolytic regimens for prosthetic valve thrombosis: the TROIA trial","volume":"6","author":"\u00d6zkan","year":"2013","journal-title":"JACC Cardiovasc Imaging"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag070\/67196124\/ytag070.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag070\/67196124\/ytag070.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/4\/ytag070\/67196124\/ytag070.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T05:47:03Z","timestamp":1777268823000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag070\/8503212"}},"subtitle":[],"editor":[{"given":"Can","family":"Gollmann-Tepek\u00f6yl\u00fc","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Dror Ben","family":"Leviner","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Aljona","family":"Friedrich","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag070","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2026,3,2]]},"article-number":"ytag070"}}