AlTaweel, MuneeraAlSulaiman, SarahAlMukhaylid, SarahMemon, FahadAlAnazi, FaisalGado, WaleedNaseef, TarekAlMakhayitah, MunirahAlokifi, MohannadAlazmi, AbdulazizAlismail, AsmaAlsultan, Nada2023-07-212023-07-212022-05AlTaweel Muneera, AlSulaiman Sarah, AlMukhaylid Sarah, Memon Fahad, AlAnazi Faisal, Gado Waleed, Naseef Tarek, AlMakhayitah Munirah, Alokifi Mohannad, Alazmi Abdulaziz, Alismail Asma, Alsultan Nada. A Case Report of Successful Fibrinolysis in a Multiple Coronary Ectasia ST-segment Elevation Myocardial Infarction Validated by Coronary Angiography. Cardiology and Angiology: An International Journal. 2022 May; 11(4): 68-732347-520Xhttp://imsear.searo.who.int/handle/123456789/220230Coronary artery ectasia (CAE) often presents in the form of an acute coronary syndrome (ACS) caused by slow blood flow leading to thrombus formation in ectatic coronary arteries. The usual approach is thrombectomy with intracoronary thrombolysis but often does not guarantee immediate blood flow. A 45-year-old male presented with anginal chest pain and was diagnosed with ST-segment elevation myocardial infarction (STEMI), managed Immediately with tissue plasminogen activator(t-PA) followed later with coronary angiography revealing diffused Multiple coronary ectasia MCEA with no identified culprit lesions afterward. The patient was followed up periodically, with favorable outcomes on daily aspirin, direct oral anticoagulant (DOAC), and guideline-directed medical therapy (GDMT) for coronary artery disease (CAD) and reduced ejection fraction heart failure (HF-rEF). This case management strategy was dictated by available resources at the time of presentation; however, it signifies the importance and favorable outcome of thrombolysis in CEA/STEMI patients. Future large-scale studies are required toward defining the duration as well as the choice of long-term anticoagulation.Coronary artery ectasiaST-segment elevation myocardial infarctionFibrinolysisThrombolysis.Journal ArticleIndiaKing Abdulaziz Hospital, MNGHA, Al Ahsa, Saudi ArabiaKing Abdullah International Medical Research Center (KAIMRC), Al Ahsa, Saudi ArabiaCollege of Applied Medical Sciences (CoAMS-A), King Saud Bin Abdulaziz University for Health Sciences -KAIMRC/ KAH, National Guard Health Affairs, Al-Ahsa, Saudi Arabia.