Ovarian Mass Causing Paradoxical MI and Leg Ischaemia
Paradoxical embolus through a patent foramen ovale is a well-reported phenomenon. Clinical consequences include stroke, intestinal infarction, lower limb ischaemia, and even acute myocardial infarction (MI), via embolisation to the coronary arteries. We present a case of acute MI, cardiogenic shock,...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | Case Reports in Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/702509 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849405108575535104 |
|---|---|
| author | K. J. Griffin M. A. Bailey J. P. Greenwood L. Barker T. Nicholson D. J. A. Scott |
| author_facet | K. J. Griffin M. A. Bailey J. P. Greenwood L. Barker T. Nicholson D. J. A. Scott |
| author_sort | K. J. Griffin |
| collection | DOAJ |
| description | Paradoxical embolus through a patent foramen ovale is a well-reported phenomenon. Clinical consequences include stroke, intestinal infarction, lower limb ischaemia, and even acute myocardial infarction (MI), via embolisation to the coronary arteries. We present a case of acute MI, cardiogenic shock, and cardiac arrest caused not by this mechanism, but by embolisation of thrombotic material to the aortic root with transient complete occlusion of the left main stem (LMS) coronary artery. During percutaneous coronary intervention to treat this occlusion the thrombus became lodged at the aortic bifurcation causing lower limb ischaemia. Despite successful treatment of this via bilateral groin exploration and thromboembolectomy the patient became increasingly acidotic and an abdominal and pelvic CT scan was performed. This revealed the source of the thrombus to be the patient’s congested and compressed pelvic veins which were the result of a large, previously undiagnosed ovarian malignancy with metastatic spread. Although very unusual we feel this case highlights an important differential in the diagnosis of anterolateral MI and images similar to those presented here are previously unreported in the literature. |
| format | Article |
| id | doaj-art-46c0d080ea8f4a929f3b75b4d71dc754 |
| institution | Kabale University |
| issn | 2090-6986 2090-6994 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Vascular Medicine |
| spelling | doaj-art-46c0d080ea8f4a929f3b75b4d71dc7542025-08-20T03:36:45ZengWileyCase Reports in Vascular Medicine2090-69862090-69942012-01-01201210.1155/2012/702509702509Ovarian Mass Causing Paradoxical MI and Leg IschaemiaK. J. Griffin0M. A. Bailey1J. P. Greenwood2L. Barker3T. Nicholson4D. J. A. Scott5Leeds Vascular Institute, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UKLeeds Vascular Institute, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UKYorkshire Heart Centre, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UKDepartment of Pathology, Leeds Teaching Hospitals Trust, Leeds LS1 3EX, UKDepartment of Interventional Radiology, Leeds Teaching Hospitals Trust, Leeds LS1 3EX, UKLeeds Vascular Institute, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UKParadoxical embolus through a patent foramen ovale is a well-reported phenomenon. Clinical consequences include stroke, intestinal infarction, lower limb ischaemia, and even acute myocardial infarction (MI), via embolisation to the coronary arteries. We present a case of acute MI, cardiogenic shock, and cardiac arrest caused not by this mechanism, but by embolisation of thrombotic material to the aortic root with transient complete occlusion of the left main stem (LMS) coronary artery. During percutaneous coronary intervention to treat this occlusion the thrombus became lodged at the aortic bifurcation causing lower limb ischaemia. Despite successful treatment of this via bilateral groin exploration and thromboembolectomy the patient became increasingly acidotic and an abdominal and pelvic CT scan was performed. This revealed the source of the thrombus to be the patient’s congested and compressed pelvic veins which were the result of a large, previously undiagnosed ovarian malignancy with metastatic spread. Although very unusual we feel this case highlights an important differential in the diagnosis of anterolateral MI and images similar to those presented here are previously unreported in the literature.http://dx.doi.org/10.1155/2012/702509 |
| spellingShingle | K. J. Griffin M. A. Bailey J. P. Greenwood L. Barker T. Nicholson D. J. A. Scott Ovarian Mass Causing Paradoxical MI and Leg Ischaemia Case Reports in Vascular Medicine |
| title | Ovarian Mass Causing Paradoxical MI and Leg Ischaemia |
| title_full | Ovarian Mass Causing Paradoxical MI and Leg Ischaemia |
| title_fullStr | Ovarian Mass Causing Paradoxical MI and Leg Ischaemia |
| title_full_unstemmed | Ovarian Mass Causing Paradoxical MI and Leg Ischaemia |
| title_short | Ovarian Mass Causing Paradoxical MI and Leg Ischaemia |
| title_sort | ovarian mass causing paradoxical mi and leg ischaemia |
| url | http://dx.doi.org/10.1155/2012/702509 |
| work_keys_str_mv | AT kjgriffin ovarianmasscausingparadoxicalmiandlegischaemia AT mabailey ovarianmasscausingparadoxicalmiandlegischaemia AT jpgreenwood ovarianmasscausingparadoxicalmiandlegischaemia AT lbarker ovarianmasscausingparadoxicalmiandlegischaemia AT tnicholson ovarianmasscausingparadoxicalmiandlegischaemia AT djascott ovarianmasscausingparadoxicalmiandlegischaemia |