Paradoxical coronary embolism in a young woman

Acute ST-elevation myocardial infarction secondary to paradoxical embolism

“…Greig et al [6] recently reported a similar case of a young female smoker taking the oral contraceptive pill who was admitted with an acute anterior STEMI; bubble contrast echocardiography revealed a moderate sized patent foramen ovale with no source of embolus found in the venous system, thereby fulfilling 2 out of the 3 criteria for presumptive diagnosis of paradoxical embolism. Our patient was also a young female smoker taking the oral contraceptive pill admitted with an anterior STEMI and fulfilled all 3 criteria of a presumptive paradoxical embolism [2].…”

“…Thus a diagnosis of intracardiac shunting should be suspected in patients with pulmonary emboli with other systemic embolic manifestations. Paradoxical coronary embolism is a rare but recognized clinical entity [4][5][6]. Transoesophageal echocardiography is a Fig.…”

Acute myocardial infarction and transient ischemic attack in a patient with lone atrial fibrillation and normal coronary arteries

“…The topography of the coronary ostiums inside the sinuses of valsava, protects them against the aortic jet and the small particles that it may carry. Though it is occasionally referred in literature, it has been described as a complication of various cardiac diseases such as atrial fibrillation [17], dilated cardiomyopathy [18,19], infective endocarditis [20], prosthetic valve [21] or even deep venous thrombosis [22] (paradoxical embolism). The embolisms were attributed to poor anticoagulation, high coagulability or defective C or S protein.…”

Thrombus crossing through a patent foramen ovale

“…A PFO may allow the passage of embolic material from the venous to the arterial circulation causing paradoxical embolism in various sites [2,3]. Stroke is an important cause of death and long-term disability worldwide.…”