Why the study?
Cases of paradoxical embolism from venous thrombosis causing acute myocardial infarction are seldom reported and can be missed without further workup in patients lacking CAD risk factors.
Highlights the importance of considering paradoxical embolism in patients presenting with acute MI without underlying risk factors for coronary artery disease.
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Alerts clinicians to evaluate for shunts in cryptogenic MI; leaves open optimal management of PFO-related paradoxical embolism.
Paradoxical embolism (PDE) originates in the venous system and ends up in the arterial circulation via cardiac or pulmonary shunts. Cases of PDE from venous thrombosis resulting in acute myocardial infarctions (MIs) are seldom reported in the literature. Diagnoses can often be missed if further workups are not pursued in patients without any underlying risk factors for coronary artery disease (CAD). Here, we report a case of a paradoxical embolus that crossed the patent foramen ovale (PFO), causing ST-elevation MI (STEMI) from an embolized venous thrombus originating in the left distal posterior tibial vein.
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Josephs et al. (2023) studied this question.
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