Successful removal of a paradoxical coronary embolus using an aspiration catheter

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.

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

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

Coronary aspiration embolectomy and systemic anticoagulation.