{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:40:01Z","timestamp":1756316401823,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,19]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Rheumatic heart disease is an important cause of mortality and morbidity in developing countries, and is the leading cause of triple valve replacement. Myocardial infarction (MI) in such cases can be due to the coronary embolism from the prosthetic valves or due to atherosclerotic vascular disease. Intravascular imaging helps in delineating the cause. We present a case of a 34-year-old premenopausal woman with no conventional cardiovascular risk factors and had triple valve replacement 4 years ago and anterior wall MI with cardiogenic shock and left ventricular failure. She was managed with mechanical ventilation, thrombolysis, diuretics, double antiplatelets and anticoagulation with low molecular weight heparin. Intravascular ultrasound showed a lipid-rich plaque with associated plaque rupture and thrombosis. Intravascular imaging helps in delineating the cause of MI and further management. Atherosclerotic MI in a patient with no conventional risk factors is rare and needs to be considered.<\/jats:p>","DOI":"10.1136\/bcr-2020-240732","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T11:55:13Z","timestamp":1626782113000},"page":"e240732","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Acute myocardial infarction in a young patient with triple valve replacement"],"prefix":"10.1136","volume":"14","author":[{"given":"Yash Paul","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1681-5197","authenticated-orcid":false,"given":"Krishna","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant Kumar","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"2025082710111064000_14.7.e240732.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008729"},{"key":"2025082710111064000_14.7.e240732.2","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.ihj.2014.03.010","article-title":"Incidence and patterns of valvular heart disease in a tertiary care high-volume cardiac center: a single center experience","volume":"66","author":"Manjunath","year":"2014","journal-title":"Indian Heart J"},{"key":"2025082710111064000_14.7.e240732.3","article-title":"Multiple and mixed valvular heart diseases","volume":"11","author":"Unger","year":"2018","journal-title":"Circulation"},{"key":"2025082710111064000_14.7.e240732.4","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-88-2-155"},{"key":"2025082710111064000_14.7.e240732.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2004.10.006"},{"key":"2025082710111064000_14.7.e240732.6","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/0002-8703(89)90249-4","article-title":"Thromboembolism in an angiographically normal coronary artery","volume":"118","author":"Moriuchi","year":"1989","journal-title":"Am Heart J"},{"key":"2025082710111064000_14.7.e240732.7","article-title":"Optical coherence tomography imaging in acute coronary syndromes","volume":"2011","author":"Kubo","year":"2011","journal-title":"Cardiol Res Pract"},{"key":"2025082710111064000_14.7.e240732.8","first-page":"129","article-title":"Prevalence of coronary artery disease in patients with rheumatic heart disease in the current era","volume":"56","author":"Jose","year":"2004","journal-title":"Indian Heart J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:11:16Z","timestamp":1756314676000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":8,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,20]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2020-240732"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240732","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}