Think outside the coronary artery: Extremely rare case of STEMI in young man

Abstract

Acute myocardial infarction caused by a bronchogenic cyst is a very rare pathology. It occurs as a result of external compression of the coronary artery by the cyst, leading to myocardial ischemia. The present case illustrates that a bronchogenic cyst, which is generally considered to be a chronic disease entity with gradual onset of symptoms, can manifest acutely as a life-threatening condition. Timely invasive coronary intervention is critical in the acute management of this complication while multimodality imaging assessment is essential in the subsequent management of the underlying etiology.

Hydropneumothorax: A Presentation of Infected Bronchogenic Cyst

“…Approximately 45% of patients with bronchogenic cysts develop severe fatal complications like life-threatening hemoptysis, pneumothorax, pleuritis, esophageal compression, and post-obstructive pneumonia [ 6 ]. Some rare complications include superior vena cava syndrome and fatal myocardial infarction secondary to compression of the left main coronary artery [ 15 , 16 ].…”

“…An array of pathologies can mimic bronchogenic cysts. The differential diagnosis of bronchogenic cysts includes neoplasms, granulomas, hematomas, vascular malformations, lung sequestration, lung abscesses, infected bullae, hydatid cysts, inflammatory lymphadenopathy, and neuro-enteric, pericardial or esophageal duplication cysts [ 16 ]. Given the unusual and insignificant character of the presentation as well as the potential for life-threatening consequences with wide pathologies in differentials, prompt imaging and surgical excision of all suspected bronchogenic cysts are essential.…”

“…Another suggested alternative to surgical excision via thoracotomy is video-assisted thoracoscopy resection [ 17 ]. The acceptance of transbronchial, transesophageal, transtracheal, extrapleural, and percutaneous aspiration as alternatives to operation is low [ 16 ].…”