Open AccessSTEMI and CVA in Hypercoagulable State with Ostium Secundum Defect
Author(s) -
Mohammed AlSadawi,
Bader Madoukh,
Ayman Battisha,
Shakil Shaikh,
Jonathan D. Marmur,
Fadi Yacoub,
Samy I. McFarlane
Publication year - 2019
Publication title -
american journal of medical case reports
Language(s) - English
Resource type - Journals
eISSN - 2374-216X
pISSN - 2374-2151
DOI - 10.12691/ajmcr-7-12-5
Subject(s) - medicine , patent foramen ovale , cardiology , septum secundum , foramen secundum , thrombosis , myocardial infarction , stroke (engine) , percutaneous , mechanical engineering , engineering
Atrial septal defect (ASD) is a risk factor for multiple vascular thrombotic events, which can occur either sequentially or simultaneously. In this report we present a case of ST-elevation myocardial infarction (STEMI) and cerebrovascular accident (CVA). The severity of adverse cardiovascular or cerebrovascular events can be increased by the presence of specific type of ASD, such as a patent foramen ovale (PFO) or osteum secundum defect. This case report discusses a unique presentation of a 48-year old male on warfarin therapy for a history of cerebral venous thrombosis (CVT) who subsequently presented with simultaneous STEMI with CVA, and who was incidentally found to have an ostium secundum defect on echocardiography. He was emergently taken for cardiac catheterization, which revealed significant proximal LAD occlusion. There has been a long standing debate within the international scientific communities regarding the therapeutic benefit of PFO closure for long-term secondary prevention of recurrence CVA. We discuss the different points of view regarding PFO closure for secondary prevention of CVA with a review of the literature on this rather controversial topic.