Acute myocardial infarction caused by paradoxical tumorous embolism as a manifestation of hepatocarcinoma.
A 71 year old patient presented with a non-ST segment elevation acute myocardial infarction. The echocardiogram showed several masses attached to the interatrial septum. Several days after admission the patient died. A postmortem examination found a large hepatocarcinoma with intravascular and intracardiac metastases and several myocardial infarctions of different ages. The infarctions had been caused by coronary paradoxical embolisms through a patent foramen ovale and contained neoplastic cells from the liver carcinoma, which had not been diagnosed. The cause of death was a massive pulmonary embolism.
Diaz Castro
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Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. odiazcastro@hotmail.com
Bueno
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Nebreda
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D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000556:secondary*; D019320:Embolism, Paradoxical / Q000150:complications*; D017809:Fatal Outcome; D006338:Heart Neoplasms / Q000556:secondary*; D006344:Heart Septal Defects, Atrial / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D009360:Neoplastic Cells, Circulating