Coronary artery thromboembolism from left appendage mural thrombus- a rare complication from atrial fibrillation

Forensic Sci Med Pathol. 2021 Sep;17(3):522-525. doi: 10.1007/s12024-021-00372-2. Epub 2021 Apr 23.


A 54-year-old man with recurrent, persistent atrial fibrillation was found dead unexpectedly. He was reportedly non-compliant with his medications and was not on anti-coagulant therapy. He was found dead in his residence after complaining of abdominal discomfort a day prior to death. Postmortem examination revealed a thromboembolus occluding the left anterior descending coronary artery that originated from a mural thrombus in the left appendage, in addition to kidney infarcts. Although atrial fibrillation-related thromboembolism is often speculated to be a cause of myocardial infarction with non-obstructive coronary arteries, supporting pathological evidence is rare. This case documents radiological, macroscopic and microscopic images of this important complication from atrial fibrillation.

Keywords: Atrial fibrillation; Autopsy; Coronary artery; Postmortem; Thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Atrial Fibrillation* / complications
  • Coronary Vessels
  • Heart Diseases*
  • Humans
  • Male
  • Middle Aged
  • Thromboembolism* / etiology
  • Thrombosis*