Greig Lynn D, Leslie Stephen J, Denvir Martin A
Int J Cardiol. 2007 Jan 31;115(1):e17-9. doi: 10.1016/j.ijcard.2006.07.070. Epub 2006 Oct 16.
A 31-year-old female smoker on the combined oral contraceptive pill presented late with an anterior myocardial infarction. At emergency coronary angiography she was found to have a coronary artery thrombus occluding the left anterior descending artery, with no other coronary artery disease. Subsequent saline bubble contrast echocardiography revealed a patent foramen ovale. The presumptive diagnosis was paradoxical coronary artery embolism resulting in myocardial infarction. We suggest that all patients with coronary artery thrombus and limited evidence of atheromatous disease be considered for contrast echocardiography to exclude a patent foramen ovale. However, whether a patent foramen ovale in this context should be closed remains uncertain.
一名31岁服用复方口服避孕药的吸烟女性患者因前壁心肌梗死前来就诊，就诊时间较晚。在急诊冠状动脉血管造影检查中，发现她的左前降支动脉被冠状动脉血栓阻塞，无其他冠状动脉疾病。随后的生理盐水气泡对比超声心动图显示卵圆孔未闭。推测诊断为反常冠状动脉栓塞导致心肌梗死。我们建议，对于所有冠状动脉血栓形成且动脉粥样硬化疾病证据有限的患者，应考虑进行对比超声心动图检查以排除卵圆孔未闭。然而，在这种情况下卵圆孔未闭是否应予以封堵仍不确定。
