Acute coronary syndrome revealing aortic prosthetic valve dysfunction: A Case Report with Literature Review

Coronary embolism is an uncommon cause of ST-segment elevation myocardial infarction (STEMI), typically occurring in patients with an underlying embolic substrate. Mechanical prosthetic heart valves represent a major predisposing factor, particularly in the presence of prosthetic dysfunction. We report the case of a 61-year-old postmenopausal woman with a history of double mitral and aortic valve replacement using mechanical prostheses (ATS No. 29 in the mitral position and St. Jude Medical No. 17 in the aortic position), who presented with acute chest pain and apicolateral ST-segment elevation. Diagnostic investigations revealed coronary embolism secondary to prosthetic valve thrombosis with immobilization of one leaflet of the aortic prosthesis. This case highlights the pivotal role of multimodal cardiac imaging in establishing the etiological diagnosis and guiding optimal management.