Thromboembolism in the left main coronary artery of a patient with membranous nephropathy: a case report.

BACKGROUND

Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults and a well-established risk factor for hypercoagulability. Although venous thromboembolism is frequently documented, arterial thrombosis-particularly acute thrombosis of the left main coronary artery (LMCA)-remains exceedingly rare.

CASE PRESENTATION: We report a fatal case of a 48-year-old male with a 10-year history of MN who presented with intermittent chest pain for 17 h and a marked elevation in troponin levels. Emergency coronary angiography revealed extensive thrombosis in the LMCA. Despite thrombus aspiration and stent implantation, the patient developed refractory cardiogenic shock and died.

CONCLUSION

Acute LMCA thrombosis associated with MN is a rare occurrence. This case highlights that the hypercoagulable state linked to MN is not confined to venous thromboembolic events and may, in rare instances, lead to fatal arterial thrombosis.