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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

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Myocardial infarction due to paradoxical embolism in a patient with large atrial septal defect

Florim Cuculi1, Mario Togni, Bernhard Meier

  • 1Department of Cardiology, University Hospital Bern, Switzerland.

The Journal of Invasive Cardiology
|October 7, 2009
PubMed

Insights

A patient with heart attack had a large atrial septal defect (ASD) found and closed during treatment. This case highlights the importance of checking for ASD in heart attack patients to prevent future embolic events.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Echocardiography

Background:

  • Acute myocardial infarction (MI) can result from coronary artery occlusion.
  • Embolic events are a potential cause of MI.
  • Atrial septal defects (ASDs) are congenital heart conditions that can be associated with paradoxical embolism.

Observation:

  • A patient presented with acute inferior myocardial infarction and embolic occlusion in the left anterior descending and right coronary arteries.
  • Transesophageal echocardiography revealed a large atrial septal defect (ASD).

Findings:

  • The ASD was successfully closed during the same session as coronary angiography and percutaneous coronary intervention.
  • The patient's presentation suggests a link between the undiagnosed ASD and the embolic coronary occlusions.

Implications:

  • Interventional cardiologists should consider screening for patent foramen ovale or ASD in cases of unexplained embolic coronary occlusions.
  • Prompt percutaneous closure of detected ASDs may prevent recurrent embolic events and improve patient outcomes.
  • This case underscores the importance of integrating echocardiography and interventional procedures for comprehensive cardiac care.

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