Left anterior descending artery thrombosis following COVID vaccination
Presentation
2 day history of headache and 24 hour history of central chest pain. D-dimer of over 9000, platelets 52. Astra-Zeneca COVID vaccination 9 days previously, no other relevant past medical history. Has already had normal CTPA and normal CT venogram of the head.
Patient Data
Right dominant coronary system.
Large thrombus within the mid-distal LAD (across origin of D2). Very small D1 vessel. Incidental short section of LAD myocardial bridging.
Otherwise the coronary arteries are normal.
Case Discussion
This was an interesting case of acute LAD occlusion in a patient without previous cardiac history. This was felt to be a case of vaccine induced thrombosis and thrombocytopenia (VITT). VITT is more frequently associated with cerebral venous sinus thrombosis and pulmonary thromboembolism which makes this case a bit unusual! The thrombus had resolved on follow up imaging 10 days later.
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