Left Main Coronary Artery Thrombosis with Acute Myocardial Infarction: A Management Dilemma

Abstract Left main coronary artery (LMCA) thrombosis with acute myocardial infarction (MI) is a rare condition with very high mortality. The low incidence of this condition and exclusion of LMCA thrombus patients from clinical trials prevent the development of optimal management strategy in these patients. Therefore, there are no clear-cut guidelines describing an evidence-based approach for this condition. We describe a patient with LMCA thrombosis presenting with acute MI, who was found to have hypercoagulable state related to homocysteinemia on further work-up. This case highlight the challenges faced during the management of this rare condition due to lack of clear-cut guidelines describing an evidence-based approach.