Successful removal of a paradoxical coronary embolus using an aspiration catheter.
BACKGROUND
A 28-year-old man presented at hospital with persistent pain in his chest and left arm, a paced rhythm on electrocardiography and elevated levels of cardiac enzymes. He was known to have patent foramen ovale and a dual-chamber pacemaker, which had been implanted following electrophysiological ablation to treat supraventricular tachycardia 3 years previously. The patient did not have a history of cardiovascular risk factors, recent travel, immobilization or clinical features of infection, and he was not taking any medication.


METHODS
Electrocardiography, cardiac enzyme studies, coronary angiography and transthoracic echocardiography.


METHODS
Acute myocardial infarction, paradoxical coronary embolus and patent foramen ovale.


RESULTS
Coronary aspiration embolectomy and systemic anticoagulation.
Wilson
Andrew M
AM
Interventional Cardiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA. awilson@cvmed.stanford.edu
Ardehali
Reza
R
Brinton
Todd J
TJ
Yeung
Alan C
AC
Vagelos
Randall
R
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D017128:Embolectomy / Q000379:methods*; D019320:Embolism, Paradoxical / Q000209:etiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006344:Heart Septal Defects, Atrial / Q000150:complications; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D010138:Pacemaker, Artificial / Q000009:adverse effects; D016896:Treatment Outcome
D000925:Anticoagulants