Unique Case of ST-Segment-Elevation Myocardial Infarction Related to Paradoxical Embolization and Simultaneous Pulmonary Embolization Clinical Considerations on Indications for Patent Foramen Ovale Closure in No-Guidelines Land

Article

关键词: MAIN CORONARY-ARTERY;    TASK-FORCE;    EMBOLISM;    MORPHOLOGY;    STROKE;    ECHOCARDIOGRAPHY;    MANAGEMENT;    DIAGNOSIS;   

DOI  :  10.1161/CIRCULATIONAHA.114.009846

来源: SCIE

【 摘 要 】

A 69-year-old man with no history of cardiac disease collapsed at home shortly after chest pain appearance. The ECG performed by paramedics during transportation and sent by the LifeNet system for evaluation to the Cardiology Center shows atrial fibrillation (AF) with a regular slow rhythm of 50 beats/min, suggesting complete heart block, ST-segment elevation in inferior and precordial V3 through V6 leads, ST-segment depression in aVL and in precordial V1 to V2 leads (Figure 1A). The clinical presentation and ECG allow for the diagnosis of ST-segmentelevation myocardial infarction (STEMI) and the patient receives aspirin 300 mg, clopidogrel 600 mg, unfractionated heparin 5000 IU, and morphine 5 mg IV on the way to the hospital. Within 3 hours after the onset of chest pain, the patient is presented to the emergency department of the nearest hospital with a 24/7 cardiac catheterization facility.

【 授权许可】

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