Carlos E. García-Morón, Servicio de Cardiología, Clínica Universitaria Colombia - Fundación Universitaria Sanitas, Bogotá, Colombia
Nelson L. Moreno-Ruiz, Servicio de Cardiología, Clínica Universitaria Colombia. Bogotá, Colombia
Carlos A. Fuentes-Pérez, Servicio de Cardiología, Clínica Universitaria Colombia. Bogotá, Colombia
Diana Vargas-Vergara, Servicio de Cardiología, Clínica Universitaria Colombia. Bogotá, Colombia
Coronary artery ectasia (CAE) is characterized by diffuse arterial dilatation associated with altered flow dynamics and an increased thrombotic risk, particularly in Markis type I classification. We report the case of a 62-year-old man with multivessel CAE and six recurrent myocardial infarctions. While on warfarin therapy, he experienced a new ischemic event in the setting of suboptimal time in therapeutic range (50%). Given this situation, therapy was switched to rivaroxaban plus clopidogrel. This case highlights the challenges of antithrombotic management in severe CAE and describes a therapeutic strategy in a difficult-to-control clinical scenario.
Keywords: Coronary artery ectasia. Myocardial infarction. Anticoagulants.