Microvascular coronary artery embolism presenting as an OHCA STEMI call detected by CMRI

Abstract

We describe a case of coronary artery embolism leading to an out-of-hospital cardiac arrest (OHCA) in which the diagnosis was achieved with utilisation of cardiac magnetic resonance imaging. The patient was otherwise well prior to this episode. Emergency diagnostic coronary angiography revealed patent arteries with TIMI 3 flow. Subsequent cardiac magnetic resonance imaging demonstrated myocardial infarction and focal microvascular obstruction in the infarcted territory. This report describes an uncommon case presentation, highlights areas for improvement in diagnostic criteria, and briefly discusses the currently available data regarding coronary artery embolism.