Acute myocardial infarction caused by paradoxical coronary embolization in a patient with a patent foramen ovale.
We describe the case of a young woman without cardiac risk factors who had an acute inferoapical myocardial infarction. Coronary angiographic appearance was consistent with thrombus in the distal left anterior descending coronary artery. A patent foramen ovale with moderate right-to-left shunting after the Valsalva maneuver was detected by contrast transesophageal echocardiography. No other cardioembolic source was identified. Paradoxical embolization through a patent foramen ovale is a rare phenomenon, which appeared to have resulted in myocardial infarction in this patient.
Gersony
D R
DR
Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA. drg5@columbia.edu
Kim
S H
SH
Di Tullio
M
M
Fard
A
A
Rabbani
L
L
Homma
S
S
D000328:Adult; D017023:Coronary Angiography; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000150:complications*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology*