Work

Embolic Myocardial Infarction

Year: 2025

Type: article

Abstract: BACKGROUND: The simultaneous occurrence of pulmonary embolism (PE) and myocardial infarction due to a paradoxical embolism through a patent foramen ovale (PFO) is a rare but potentially life-threatening clinical condition. We present an exceptionally rare case of concomitant ST-segment elevation myocardial infarction (STEMI) and acute PE in a young patient with a large PFO, which ultimately led to the diagnosis of an underlying malignancy. CASE SUMMARY: A 36-year-old woman presented with lateral STEMI. Coronary angiography revealed a large thrombus in a left circumflex artery without atherosclerosis. Transthoracic echocardiography revealed reduced right ventricle function and PFO with a right-to-left shunt. CT pulmonary angiogram confirmed bilateral PE. Further investigation revealed a mass in the left distal femur, diagnosed as myxoid sarcoma via biopsy. DISCUSSION: This case highlights the importance of considering embolic sources in young patients with STEMI, especially when no significant coronary artery disease is found.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104630