Dietz Denise M, Cleveland John D, Chewning Kelly G, Dent John M, Kern John A, Keeley Ellen C
Department of Medicine, University of Virginia, Charlottesville, VA, USA ; Division of Cardiology, University of Virginia, Charlottesville, VA, USA.
J Cardiol Cases. 2013 May 1;7(5):e145-e148. doi: 10.1016/j.jccase.2013.01.003.
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.
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.
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。
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。
