Embolic Myocardial Infarction: Unveiling a Hidden, Life-Threatening Disorder
Mohammad AlTermanini1, Adalah Alqalalwah1, Shabib AlAasmi1
1Cardiology Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Background:
The simultaneous occurrence of pulmonary embolism (PE) and myocardial infarction due to a paradoxical embolism through a patent foramen ovale (PFO) is a rare but potentially life-threatening clinical condition. We present an exceptionally rare case of concomitant ST-segment elevation myocardial infarction (STEMI) and acute PE in a young patient with a large PFO, which ultimately led to the diagnosis of an underlying malignancy.
Case Summary:
A 36-year-old woman presented with lateral STEMI. Coronary angiography revealed a large thrombus in a left circumflex artery without atherosclerosis. Transthoracic echocardiography revealed reduced right ventricle function and PFO with a right-to-left shunt. CT pulmonary angiogram confirmed bilateral PE. Further investigation revealed a mass in the left distal femur, diagnosed as myxoid sarcoma via biopsy.
Discussion:
This case highlights the importance of considering embolic sources in young patients with STEMI, especially when no significant coronary artery disease is found.
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