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Gustav Smith

Associate professor

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

Author

  • Gustav Smith
  • Sasha Koul
  • Anders Roijer
  • Jasminka Holmqvist
  • Inger Keussen
  • Wojciech Cwikiel
  • Bertil Öhlin
  • David Erlinge

Summary, in English

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.

Department/s

  • Cardiology
  • Diagnostic Radiology, (Lund)
  • Internal Medicine - Epidemiology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2013

Language

English

Pages

131-136

Publication/Series

European Heart Journal: Acute Cardiovascular Care

Volume

2

Issue

2

Document type

Journal article

Publisher

Oxford University Press

Topic

  • Cardiac and Cardiovascular Systems

Status

Published

Research group

  • Internal Medicine - Epidemiology

ISBN/ISSN/Other

  • ISSN: 2048-8734