Introduction:
Nonatherosclerotic causes of STEMI may be life-threatening and can occur even in the absence of significant cardiovascular risk factors. A nonathersclerotic direct coronary thromboembolism is a rare occurrence. It requires further investigation and the initiation of appropriate therapy immediately.
Coronary embolism occurs in about 3% of patients with acute coronary syndrome [1]. It may be paradoxical, direct, or iatrogenic. An embolism breaks off an initial source such as a thrombus and then causes a decrease or blockage of blood flow up stream.
Oral contraceptive pills (OCPs) are used widely to prevent unwanted pregnancies and dysfunctional uterine bleeding. There has been much research on the increased risk of thromboembolic events from these drugs. Norgestimate / Ethinyl Estradiol is a progesterone and estrogen combination used to prevent ovulation and pregnancy. OCPs including Norgestimate / Ethinyl Estradiol are known to significantly increase the risk of clot formation in female smokers who are above the age of 35 [2].
Herein we report a 41-year-old female who presented with an inferior STEMI and was found to have a saddle clot (thrombus) involving the distal left main artery, left circumflex, and proximal LAD. Her only cardiac risk factors were smoking and the use of oral contraceptives.