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Acute right ventricular failure caused by concomitant coronary and pulmonary embolism: successful treatment with endovascular coronary and pulmonary thrombectomy.

Smith, Gustav LU ; Koul, Sasha LU ; Roijer, Anders LU ; Holmqvist, Jasminka; Keussen, Inger LU ; Cwikiel, Wojciech LU ; Öhlin, Bertil LU and Erlinge, David LU (2013) In European Heart Journal. Acute Cardiovascular Care. 2(2). p.131-136
Abstract
Patent foramen ovale (PFO) is present in approximately 25% of the general population. PFO is characterized by intermittent shunting of blood from the right to the left atrium, especially in the context of increased right-sided filling pressures, with risk of paradoxical embolism. We describe a 69-year-old woman presenting with acute chest pain, severe dyspnoea, and acute inferolateral ST-segment elevation on the electrocardiogram. The patient was diagnosed with myocardial infarction and failure of the right cardiac ventricle, which was considered to be secondary to extensive pulmonary embolism leading to increased filling pressures and paradoxical coronary embolism. The patient underwent emergent percutaneous interventions with coronary... (More)
Patent foramen ovale (PFO) is present in approximately 25% of the general population. PFO is characterized by intermittent shunting of blood from the right to the left atrium, especially in the context of increased right-sided filling pressures, with risk of paradoxical embolism. We describe a 69-year-old woman presenting with acute chest pain, severe dyspnoea, and acute inferolateral ST-segment elevation on the electrocardiogram. The patient was diagnosed with myocardial infarction and failure of the right cardiac ventricle, which was considered to be secondary to extensive pulmonary embolism leading to increased filling pressures and paradoxical coronary embolism. The patient underwent emergent percutaneous interventions with coronary thrombus extraction and pulmonary thrombus fragmentation and local thrombolysis. The patient was free of symptoms at follow up 6 months later and echocardiography showed substantially improved right ventricular function. We discuss issues related to the diagnosis, treatment, and secondary prevention for patients with concomitant pulmonary and coronary arterial thrombosis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Heart Journal. Acute Cardiovascular Care.
volume
2
issue
2
pages
131 - 136
publisher
SAGE Publications Inc.
external identifiers
  • pmid:24222822
  • scopus:84901444337
ISSN
2048-8734
DOI
10.1177/2048872613486336
language
English
LU publication?
yes
id
163f3dbc-a212-4045-9047-47e0acb438ff (old id 4179468)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24222822?dopt=Abstract
date added to LUP
2013-12-03 20:27:06
date last changed
2019-08-07 02:33:51
@article{163f3dbc-a212-4045-9047-47e0acb438ff,
  abstract     = {Patent foramen ovale (PFO) is present in approximately 25% of the general population. PFO is characterized by intermittent shunting of blood from the right to the left atrium, especially in the context of increased right-sided filling pressures, with risk of paradoxical embolism. We describe a 69-year-old woman presenting with acute chest pain, severe dyspnoea, and acute inferolateral ST-segment elevation on the electrocardiogram. The patient was diagnosed with myocardial infarction and failure of the right cardiac ventricle, which was considered to be secondary to extensive pulmonary embolism leading to increased filling pressures and paradoxical coronary embolism. The patient underwent emergent percutaneous interventions with coronary thrombus extraction and pulmonary thrombus fragmentation and local thrombolysis. The patient was free of symptoms at follow up 6 months later and echocardiography showed substantially improved right ventricular function. We discuss issues related to the diagnosis, treatment, and secondary prevention for patients with concomitant pulmonary and coronary arterial thrombosis.},
  author       = {Smith, Gustav and Koul, Sasha and Roijer, Anders and Holmqvist, Jasminka and Keussen, Inger and Cwikiel, Wojciech and Öhlin, Bertil and Erlinge, David},
  issn         = {2048-8734},
  language     = {eng},
  number       = {2},
  pages        = {131--136},
  publisher    = {SAGE Publications Inc.},
  series       = {European Heart Journal. Acute Cardiovascular Care.},
  title        = {Acute right ventricular failure caused by concomitant coronary and pulmonary embolism: successful treatment with endovascular coronary and pulmonary thrombectomy.},
  url          = {http://dx.doi.org/10.1177/2048872613486336},
  volume       = {2},
  year         = {2013},
}