Recurrent Episodes of Acute Myocardial Infarction Secondary to Paradoxical Coronary Artery Embolism

Abstract

Coronary artery embolism is a rare cause of acute myocardial infarction, attributed to approximately 10% of all paradoxical embolisms. It is a condition that should be considered in patients who present with chest pain and have a low overall risk of coronary heart disease. A major risk of coronary artery embolism is the existence of a patent foramen ovale (PFO), which can be shown on bubble transthoracic echocardiography. Here we describe a case report of a 68-year-old Caucasian lady who presented with recurrent episodes of myocardial infarction secondary to a paradoxical coronary artery embolism which was likely due to a PFO. We emphasize the need for more research on the role of PFO percutaneous device closure compared to just medical therapy in those with recurrent episodes of acute myocardial infarction secondary to paradoxical coronary artery embolism. This, in turn, should provide clearer guidance in managing such patients with high risk of mortality.