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Updated: May 9, 2026

Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model
Published on: November 4, 2021
Impending paradoxical embolism presenting as myocardial infarction
Denise M Dietz1, John D Cleveland, Kelly G Chewning
1Department of Medicine, University of Virginia, Charlottesville, VA, USA ; Division of Cardiology, University of Virginia, Charlottesville, VA, USA.
Abstract:
We present a spectrum of findings with transthoracic echocardiography, coronary angiography, and open surgical exploration in a 54-year-old man who presented with an acute ST segment elevation myocardial infarction and was diagnosed with impending paradoxical emboli. He underwent successful surgical removal of the thrombus.
Learning Objective:
Impending paradoxical embolism, a biatrial thromboembolus in transit across a patent foramen ovale, is associated with a 20% mortality rate. Very rarely does it present as a ST segment elevation myocardial infarction. The optimal management (medical or surgical) for those who present with it remains a subject of debate, although surgery has been associated with less systemic embolization.
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