Intravascular ultrasound and angiographic demonstration of left main stem thrombus—high-risk presentation in a young adult with anabolic steroid abuse

Pankaj Garg, Gershan Davis, John Ian Wilson, Mohan Sivananthan

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We present a case of acute myocardial infarction in a young adult with a history of anabolic steroid abuse. On diagnostic coronary angiography and intravascular ultrasound, he was found to have a distal left main stem thrombus extending into the proximal left anterior descending artery and a large intermediate vessel. As he was hemodynamically stable and pain-free, he was managed conservatively with triple antiplatelet therapy (aspirin, clopidogrel, and abciximab). This was also to avoid the risk of ‘wiring the vessel,’ especially if there was underlying dissection. Repeat angiography a few weeks later showed complete thrombus resolution. This is the first reported case of extensive left main stem thrombus in a young patient with anabolic steroid abuse. Management of such cases is not straightforward and our case highlights one approach to both diagnosis and treatment.
Original languageEnglish
Article number125
JournalAmerican Heart Hospital Journal
Issue number2
Publication statusPublished - 1 Jan 2010

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