Acute myocardial infarction in a patient with uncorrected tetralogy of Fallot accompanied by coronary artery ectasia: A case report

• DOI: 10.1016/j.jccase.2020.10.009
• Publication Date: 2020-11-02T16:54:24Z
• Authors: Wataru Yamamoto; Satoru Otsuji; Shin Takiuchi; Mikio Kakishita; Yuji Shimatani; Katsuyuki Hasegawa; Kasumi Ishibuchi; Hiroto Tamaru; Rui Ishii; Shingo Yasuda; Yusuke Taniguchi; Sho Nakabayashi; Hirofumi Kusumoto; Yorihiko Higashino
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Abstract A 63-year-old male with a medical history of uncorrected tetralogy of Fallot (TOF) presented to our hospital due to acute myocardial infarction (AMI). Emergency coronary angiography (CAG) was performed and it showed a severe thrombotic stenosis in the middle right coronary artery (RCA) and total thrombotic occlusion of the posterior descending branch of the RCA. Subsequently, percutaneous coronary artery intervention (PCI) under the guidance of intravascular ultrasound (IVUS) was performed. He was discharged on the 14th day in stable condition. Nine months after the PCI procedure, coronary computed tomography angiography was performed for follow-up, which revealed tetralogy of Fallot and complete resolution of the thrombus and ectasic coronary artery without stenosis. When he was 70 years old, he was transferred to our hospital because of recurrent AMI. As emergency CAG showed total thrombotic occlusion of the middle RCA, IVUS-guided PCI was performed. We experienced a very rare case of AMI in an adult patient with uncorrected TOF accompanied by coronary artery ectasia (CAE). To the best of our knowledge, this is the first case of AMI in an adult patient with uncorrected TOF accompanied by CAE.