title: A case of paradoxical embolic ST-segment elevation myocardial infarction triggered by sleep apnea.
abstract: This report describes an obese 39-year-old man who experienced ST-segment elevation myocardial infarction with total thrombotic occlusion of the right coronary artery. Culprit vessel flow was improved by aspiration. Data suggested that myocardial infarction had resulted from paradoxical embolus via a patent foramen ovale triggered by the Mueller maneuver, which had induced negative intrathoracic pressure following an acute increase of right-heart volume in the context of obesity and sleep-disordered breathing (SDB). Obesity is increasing among younger populations and it represents a risk for SDB and thrombosis. Thus, this mechanism should be included within the differential diagnosis for myocardial infarction in young patients.
authors: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Japan. shingo@oha.toho-u.ac.jp
authors: Shingo
authors: S
authors: Kujime
authors: Hidehiko
authors: H
authors: Hara
authors: Yoshinari
authors: Y
authors: Enomoto
authors: Hisao
authors: H
authors: Yoshikawa
authors: Hideki
authors: H
authors: Itaya
authors: Mahito
authors: M
authors: Noro
authors: Makoto
authors: M
authors: Suzuki
authors: Masato
authors: M
authors: Nakamura
authors: Kaoru
authors: K
authors: Sugi
mesh_terms: D000328:Adult; D004562:Electrocardiography; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D009765:Obesity / Q000150:complications; D062645:Percutaneous Coronary Intervention; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis; D014636:Valsalva Maneuver