Key result
Massive pulmonary embolism triggers fatal acute MI via paradoxical coronary embolism across a PFO.
Why the study?
Paradoxical embolism through patent foramen ovale is a rare event with serious clinical implications that requires careful recognition and assessment.
Case Report (n=1)
This case highlights the severe prognosis of paradoxical coronary embolism through a PFO triggered by massive pulmonary embolism, emphasizing the need for careful evaluation in such patients.
May prompt PFO evaluation in PE with neurological symptoms; leaves open optimal screening and closure strategies.
OtevĹenĂŠ foramen ovale (PFO) je nejÄastÄjĹĄĂ strukturĂĄlnĂ srdeÄnĂ anomĂĄliĂ spojenou s paradoxnĂ emboliĂ. OnemocnÄnĂ zvyĹĄujĂcĂ tlak v dutinĂĄch pravĂŠho srdce, napĹ. plicnĂ embolie, mohou zpĹŻsobit otevĹenĂ PFO a zvýťit riziko prĹŻchodu trombĹŻ ze ĹžilnĂho do tepennĂŠho obÄhu. ParadoxnĂ embolie je vzĂĄcnou pĹĂhodou se zĂĄvaĹžnou prognĂłzou. Tato kazuistika popisuje pĹĂpad 77letĂŠ Ĺženy, kterĂĄ byla dopravena na oddÄlenĂ akutnĂho pĹĂjmu pro dyspnoe, zmatenost a bolest na hrudi s kardiogennĂm ĹĄokem. EKG prokĂĄzalo vĂ˝znamnou elevaci Ăşseku ST ve vysokĂ˝ch laterĂĄlnĂch svodech. Jak EKG, tak klinickĂŠ vyĹĄetĹenĂ naznaÄovalo masivnĂ plicnĂ embolii s nĂĄslednou paradoxnĂ emboliĂ pĹes PFO, coĹž vedlo k akutnĂmu infarktu myokardu. OkamĹžitÄ byla zahĂĄjena trombolytickĂĄ terapie; infuzi komplikovala bezpulsovĂĄ elektrickĂĄ aktivita vedoucĂ k ĂşmrtĂ pĹes odpovĂdajĂcĂ rozĹĄĂĹenou podporu ĹživotnĂch funkcĂ. Kazuistika upozorĹuje na vĂ˝znam rozpoznĂĄnĂ a peÄlivĂŠho zhodnocenĂ znĂĄmek a pĹĂznakĹŻ paradoxnĂ a perifernĂ embolie na podkladÄ plicnĂ embolie u pacientĹŻ s PFO.
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Morabito et al. (2020) conducted a case report in Patent foramen ovale and paradoxical coronary artery embolism (n=1). Patent foramen ovale and pulmonary embolism was evaluated. A 77-year-old woman with a patent foramen ovale experienced a fatal acute myocardial infarction due to paradoxical coronary artery embolism secondary to massive pulmonary embolism.
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