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

## TL;DR

A rare case of arterial thrombosis in a patient with membranous nephropathy highlights the risk of fatal complications beyond typical venous issues.

## Contribution

This case report documents a rare instance of acute left main coronary artery thrombosis in a patient with membranous nephropathy.

## Key findings

- The patient had a 10-year history of membranous nephropathy and presented with acute coronary thrombosis.
- Despite emergency intervention, the patient died from refractory cardiogenic shock.
- The case suggests that hypercoagulability in membranous nephropathy can lead to rare but fatal arterial events.

## Abstract

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.

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.

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.