We describe a case of a young woman requiring veno-venous extracorporeal support for severe secondary respiratory failure who developed a myocardial ischaemia due to an intermittent obstruction of the right coronary sinus by a fluttering thrombus. She was medically treated with full anticoagulation regimen, needed for the veno-venous extracorporeal membrane oxygenation support, without any other ischaemic or embolic event.
Keywords: CT coronary angiography; NSTEMI; Veno-venous extracorporeal membrane oxygenation; aortic thrombus; echocardiography.