Embolismo coronario múltiple en paciente con doble prótesis aórtica y mitral

We present a case about a 55 years old woman with aortic and mitral mechanical prosthesic valve. She had a stroke related to anticoagulation underdosing nine years ago. She has an inferior acute myocardial infarction (AMI) with ST elevation, with thrombotic coronary occlusions suggestive of multiple coronary embolism from non occlusive mitral valve thrombosis confirmed by echocardiography. We give undue emphasis to the importance of diagnostic coronary embolism suspicion in patients with prosthesis and coronary angiography without significant coronary lesions as well as the role the intracoronary imaging techniques (IVUS and OCT) play to complete the diagnosis.