{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:40:05Z","timestamp":1756323605271,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,23]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>A 77-year-old woman without traditional risk factors for coronary artery disease (CAD) underwent coronary CT-angiography for evaluation of palpitations after negative Holter monitoring and non-diagnostic ECG exercise stress test. Coronary artery calcium score was reported zero; 1 day later, she was admitted with anterior-wall ST elevation myocardial infarction. Acute left anterior descending artery thrombus was treated with mechanical thrombectomy and Percutaneous Coronary Intervention (PCI). Interestingly, the coronary arteries were angiographically normal. During hospitalisation, paroxysmal atrial fibrillation was noted followed by initiation of anticoagulation. Echocardiogram did not show thrombus or atrial shunt. Cardioversion with Sotalol was successful. Myocardial infraction was most likely cardioembolic secondary to paroxysmal atrial fibrillation\u2014consistent with longstanding history of palpitations. Accounting for 3% of acute coronary syndromes, coronary embolism is treated with therapeutic anticoagulation for at least 3\u2009months irrespective of cause and carries a higher risk of adverse cardiovascular events.<\/jats:p>","DOI":"10.1136\/bcr-2019-231996","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T08:07:48Z","timestamp":1567670868000},"page":"e231996","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Paroxysmal atrial fibrillation presenting as anterior wall STEMI in an elderly woman"],"prefix":"10.1136","volume":"12","author":[{"given":"Muhammad Asim","family":"Shabbir","sequence":"first","affiliation":[{"name":"Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-7790","authenticated-orcid":false,"given":"Muhammad Hamza","family":"Saad Shaukat","sequence":"additional","affiliation":[{"name":"Internal Medicine, Albany Medical Center Hospital, Albany, New York, USA"},{"name":"Aga Khan University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance","family":"Sullenberger","sequence":"additional","affiliation":[{"name":"Capital Cardiology Associates, Albany Medical Center Hospital, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikhail","family":"Torosoff","sequence":"additional","affiliation":[{"name":"Cardiology, Albany Medical Center Hospital, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,4]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082712174342000_12.9.e231996.1","DOI":"10.1016\/j.jcin.2017.08.057"},{"doi-asserted-by":"publisher","key":"2025082712174342000_12.9.e231996.2","DOI":"10.1161\/CIRCULATIONAHA.114.015134"},{"key":"2025082712174342000_12.9.e231996.3","article-title":"Coronary embolism among ST-segment\u2013elevation myocardial infarction patients","volume":"11","author":"Popovic","year":"2018","journal-title":"Circulation: Cardiovascular Interventions"},{"doi-asserted-by":"crossref","unstructured":"Abdu FA , Liu L , Mohammed AQ , et al . 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