A 64-year-old woman was diagnosed with colorectal cancer several months ago and was started on bevacizumab 5 mg/kg every 2 weeks in combination with 5-fluorouracil. She is brought to the emergency department by her granddaughter after she begins complaining of crushing substernal chest pain and shortness of breath. Measurement of vital signs reveals the blood pressure of 181/100 mmHg and heart rate of 87 bpm. Cardiac examination is normal, with the regular rhythm, but an ECG performed in the emergency department shows 2 mm anteroseptal ST elevation.
An ST-elevation myocardial infarction (STEMI) is suspected and a STEMI alert is called. The woman is rushed to the catheterization laboratory where she is found to have an acute thrombus in the left anterior descending coronary artery. The interventional cardiologist notes that the thrombus was embolic in nature because he did not notice any…
