以心肌梗死为表现的先兆矛盾性栓塞
Impending paradoxical embolism presenting as myocardial infarction.
作者信息
Dietz Denise M, Cleveland John D, Chewning Kelly G, Dent John M, Kern John A, Keeley Ellen C
机构信息
Department of Medicine, University of Virginia, Charlottesville, VA, USA ; Division of Cardiology, University of Virginia, Charlottesville, VA, USA.
出版信息
J Cardiol Cases. 2013 May 1;7(5):e145-e148. doi: 10.1016/j.jccase.2013.01.003.
UNLABELLED
We present a spectrum of findings with transthoracic echocardiography, coronary angiography, and open surgical exploration in a 54-year-old man who presented with an acute ST segment elevation myocardial infarction and was diagnosed with impending paradoxical emboli. He underwent successful surgical removal of the thrombus.
LEARNING OBJECTIVE
Impending paradoxical embolism, a biatrial thromboembolus in transit across a patent foramen ovale, is associated with a 20% mortality rate. Very rarely does it present as a ST segment elevation myocardial infarction. The optimal management (medical or surgical) for those who present with it remains a subject of debate, although surgery has been associated with less systemic embolization.
未标注
我们展示了一名54岁男性经胸超声心动图、冠状动脉造影及开胸手术探查的一系列结果。该男性因急性ST段抬高型心肌梗死就诊，被诊断为即将发生反常栓塞。他接受了成功的血栓手术清除。
学习目标
即将发生的反常栓塞，即穿过卵圆孔未闭的双侧心房血栓栓子，死亡率为20%。它极少表现为ST段抬高型心肌梗死。对于出现这种情况的患者，最佳治疗方法（药物治疗或手术治疗）仍存在争议，尽管手术与较少的全身栓塞相关。
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