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Possible paradoxical embolism as a rare cause for an acute myocardial infarction

Aleksandr Rovner1, Ali A Valika, Attila Kovacs

  • 1Department of Cardiology, Washington University, St. Louis, Missouri 63110, USA. arovner@im.wustl.edu

Echocardiography (Mount Kisco, N.Y.)
|May 12, 2006
PubMed

Insights

A rare paradoxical embolus caused a patient's heart attack (myocardial infarction) after a pulmonary embolism. This case highlights the importance of considering paradoxical emboli in unexplained strokes and heart attacks.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pulmonary Medicine

Background:

  • Paradoxical embolus is an uncommon cause of thromboembolic events.
  • It is implicated in cryptogenic strokes and myocardial infarctions.
  • Diagnosis and management can be challenging due to its rarity.

Observation:

  • A patient presented with acute myocardial infarction (MI) one week after being diagnosed with pulmonary embolism.
  • Further evaluation identified a patent foramen ovale and a significant thrombus in the right pulmonary artery.
  • The clinical presentation suggested a paradoxical embolus as the cause of the MI.

Findings:

  • The patient's MI was presumed to be a result of a paradoxical embolus.
  • A patent foramen ovale served as the conduit for the embolus.
  • A large thrombus in the pulmonary artery was identified.

Implications:

  • This case underscores the need to consider paradoxical emboli in patients with unexplained MI, especially those with a history of venous thromboembolism.
  • Early diagnosis and appropriate management of patent foramen ovale can prevent recurrent embolic events.
  • Reviewing literature on paradoxical emboli aids in understanding and managing such rare conditions.

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