Concomitant acute myocardial infarction and acute pulmonary embolism caused by paradoxical embolism: a case report

Background Due to its low incidence and diverse manifestations, paradoxical embolism (PDE) is still under-reported and is not routinely considered in differential diagnoses. Concomitant acute myocardial infarction (AMI) and acute pulmonary embolism (PE) caused by PDE has rarely been reported. Case p...

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Bibliographic Details
Published in:BMC cardiovascular disorders 2021-06, Vol.21 (1), p.1-6, Article 313
Main Authors: Chen, Weiwei, Yu, Zhixi, Li, Siming, Wagatsuma, Kenji, Du, Beibei, Yang, Ping
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Acute pulmonary embolism
Angiography
Care and treatment
Case Report
Causes of
Complications and side effects
Computed tomography
Diagnosis
Echocardiography
EKG
Embolism
Etiology
Heart attack
Heart attacks
Myocardial infarction
Occlusion
Pain
Paradoxical embolism
Patent foramen ovale
Patients
Prevention
Pulmonary arteries
Pulmonary artery
Pulmonary embolisms
Stenosis
Stroke
Thromboembolism
Transient ischemic attack
Trinucleotide repeats
Ultrasonic imaging
Veins & arteries
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Summary:Background Due to its low incidence and diverse manifestations, paradoxical embolism (PDE) is still under-reported and is not routinely considered in differential diagnoses. Concomitant acute myocardial infarction (AMI) and acute pulmonary embolism (PE) caused by PDE has rarely been reported. Case presentation A 45-year-old woman presented with acute chest pain and difficulty with breathing. Multiple imaging modules including ECG, echocardiography, emergency cardioangiogram (CAG), and CT angiography of the pulmonary arteries showed acute occlusion of the posterolateral artery and acute PE. After coronary aspiration, no residual stenosis was observed. One month later, a bubble study showed inter-atrial communication via a patent foramen ovale (PFO). The AMI in this patient was finally attributed to PDE via the PFO. PFO closure was performed, and long-term anticoagulation was prescribed to prevent recurrent thromboembolic events. Conclusions PDE via PFO is a rare etiology of AMI, especially in patients with concomitant AMI and PE. Clinicians should be vigilant of this possibility and close the inter-atrial channel for secondary prevention. Keywords: Acute myocardial infarction, Paradoxical embolism, Patent foramen ovale, Acute pulmonary embolism, Case report
ISSN:1471-2261
1471-2261
DOI:10.1186/s12872-021-02123-1