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

Abstract

<h4>Background</h4>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.<h4>Case presentation</h4>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.<h4>Conclusion</h4>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.