title: Saddle Pulmonary Embolism with Paradoxical Coronary Artery Embolism through a Patent Foramen Ovale.
abstract: A 35-year-old male patient was found in cardiac arrest in his vehicle, with no apparent injuries after a minor motor vehicle collision. The decedent was found to have a saddle pulmonary embolus with a thromboembolus impacted across a patent foramen ovale and a paradoxical embolism in the circumflex coronary artery, as well as significant clotting in the deep veins of both lower extremities. There were no risk factors in his history to explain the deep venous thrombosis; family history suggested the possibility of an unrecognized clotting disorder.
authors.affiliation: Eastern Virginia Medical School, 825 Fairfax Ave., Norfolk, VA, 23507.
authors.forename: Amber L
authors.initials: AL
authors.lastname: Achesinski
authors.affiliation: Office of the Chief Medical Examiner, Tidewater District: 830 Southampton Ave., Suite 100, Norfolk, VA, 23510.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Gunther
authors.affiliation: Eastern Virginia Medical School, 825 Fairfax Ave., Norfolk, VA, 23507.
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Pearman
mesh_terms: D000328:Adult; D003331:Coronary Vessels / Q000473:pathology*; D019320:Embolism, Paradoxical / Q000473:pathology*; D017809:Fatal Outcome; D054092:Foramen Ovale, Patent / Q000473:pathology*; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000473:pathology*; D020246:Venous Thrombosis / Q000473:pathology
keywords: coronary artery embolism; forensic science; hypercoagulable syndromes; manner of death; paradoxical embolism; patent foramen ovale