PubMed · 11847887
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2002-01-17. [Endothelial dysfunction moves into focus].. https://pubmed.ncbi.nlm.nih.gov/11847887/
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We describe a patient with a paradoxical coronary embolism diagnosed by transesophageal echocardiography. The patient developed a stroke followed by a myocardial infarction. Coronary angiography showed an obstruction of the left main coronary artery. Transesophageal echocardiography showed the mechanism of the neurologic and cardiac events to be a paradoxical embolism. Emergency surgical retrieval of the thrombus lodged in the left main coronary ostium and of a separate thrombus traversing a patent foramen ovale was performed. To our knowledge, direct visualization of the paradoxical coronary embolism by echocardiography has not been reported previously. We discuss mechanisms responsible for paradoxical coronary embolism and review the literature pertaining to this condition.
Platelet aggregation plays a key role in the development of complications of atherosclerosis. By inhibiting platelet aggregation in a pharmacological way complications such as myocardial infarction and sudden death may be prevented. This goes for primary as well as secondary prevention. The most relevant substances for this goal are aspirin, clopidogrel and the new glycoprotein IIb/IIIa inhibitors.