title: Myocardial ischemia: atypical presentation of an atrial septal defect in childhood.
abstract: We describe a 17-year-old male with a secundum atrial septal defect (ASD), who presented with acute myocardial ischemia. The presumptive diagnosis of a paradoxical coronary embolism was based on the demonstration of a large ASD in conjunction with normal coronary arteries, a negative endomyocardial biopsy, and a negative drug screen. After percutaneous closure with an Amplatzer device, there has been no recurrence for 2 years.
authors.affiliation: Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
authors.forename: Lars
authors.initials: L
authors.lastname: Muller
authors.forename: Terrence
authors.initials: T
authors.lastname: Dillon
authors.forename: Robert H
authors.initials: RH
authors.lastname: Beekman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004621:Embolization, Therapeutic / Q000295:instrumentation; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy