Myocardial Infarction Due to Nonvalvular Papillary Fibroelastoma of the Left Coronary Sinus: The Importance of Multimodal Imaging

Abstract

A 44-year-old woman with a history of type II diabetes and obesity presents, with a two- month history of syncope. In the week prior to presentation, she reported exertional angina. She presented to the emergency department with a 2-hour history of chest pain at rest (intensity 8/10 on the visual analog scale), that radiated to her left arm. Her blood pressure on presentation was 95/60 mmHg and heart rate was 88 bpm. The initial electrocardiogram demonstrated diffuse ST-segment depression and ST elevation in aVR (Figure 1).