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Embolic myocardial infarction associated with patent foramen ovale: a case series

https://doi.org/10.15829/1728-8800-2023-3352

Abstract

A patent foramen ovale (PFO) is a fairly common mild cardiac defect that causes a shunting across the atrial septum. PFO is also a known risk factor for cryptogenic stroke. Much less frequently, PFO is associated with non-cerebral systemic embolic events. The article describes a case series of paradoxical embolism of the coronary arteries (CA), which caused myocardial infarction (MI). The presence of PFO was confirmed by imaging techniques. Subsequently, the patients underwent successful endovascular closure of the PFO. Thus, paradoxical CA embolism is a rare and underdiagnosed cause of acute MI. It should be considered in patients with MI and a low risk of atherosclerotic coronary artery disease. However, in most cases, it is not possible to verify the source of the embolism. The significance of occluder implantation as one of the treatment tactics requires further clarification.

About the Authors

A. M. Pivtsova
I.M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



D. Yu. Shchekochikhin
I.M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



D. V. Ognerubov
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation

Moscow



A. A. Agadzhanyan
I.M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



A. A. Bogdanova
Pirogov Russian National Research Medical University
Russian Federation

Moscow



M. I. Makeev
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation

Moscow



D. V. Pevzner
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation


Е. V. Merkulov
E.I. Chazov National Medical Research Center of Cardiology
Russian Federation


D. A. Andreev
I.M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



M. Yu. Gilyarov
Pirogov Russian National Research Medical University
Russian Federation

Moscow



References

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Supplementary files

  • Patent foramen ovale, as an anatomical defect, allows right-to-left shunting to occur when right atrial pressure increases (late diastole, early systole, coughing, laughing, sneezing, and Valsalva maneuver).
  • Paradoxical coronary artery embolism is a rare, underdiagnosed, and underestimated cause of acute myocardial infarction. Its probability should be considered primarily in young or middle-aged patients with myocardial infarction (more often with ST-segment elevation), without a previous coronary history, with a low cardiovascular risk and no significant coronary atherosclerosis. However, in most cases, verifying the embolism source is not possible.

Review

For citations:


Pivtsova A.M., Shchekochikhin D.Yu., Ognerubov D.V., Agadzhanyan A.A., Bogdanova A.A., Makeev M.I., Pevzner D.V., Merkulov Е.V., Andreev D.A., Gilyarov M.Yu. Embolic myocardial infarction associated with patent foramen ovale: a case series. Cardiovascular Therapy and Prevention. 2023;22(1):3352. (In Russ.) https://doi.org/10.15829/1728-8800-2023-3352

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)