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Impending paradoxical embolism presenting as myocardial infarction.

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.

SUBMITTER: Dietz DM

PROVIDER: S-EPMC3708660 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Impending paradoxical embolism.

Project description:An impending paradoxical embolism (IPDE) is seldom observed in clinical practice. We report a case of IPDE in a 67-year-old female with severe dyspnea and hypotension, which was detected and successfully treated with emergent cardiac surgery. The optimal treatment is still controversial. We believe that emergent surgery always should be considered in patients with IPDE. <Learning objective: We report a rare case of an impending paradoxical embolism in a 67-year-old female with severe dyspnea, which was successfully treated with emergent cardiac surgery. An emergent open surgery always should be considered in patients with impending paradoxical embolism.>.

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