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European Journal of Echocardiography 2007 8(5):390-392; doi:10.1016/j.euje.2006.04.004
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Copyright © 2006, The European Society of Cardiology

Paradoxical coronary emboli following a long-haul airline flight

Rockesh Gurtua, Richard Grocott-Masona, Mark Masonb, Charles Ilsleyb and Simon William Dubreya,*

aDepartment of Cardiology, Hillingdon Hospital, Pield Heath Road, Uxbridge, Midddlesex UB8 3NN, UK
bDepartment of Cardiology, Harefield Hospital, Harefield, Middlesex, UK

Received 19 January 2006; received in revised form 24 March 2006; accepted after revision 14 April 2006.

simon.dubrey{at}thh.nhs.uk

* Corresponding author. Tel.: +44 1895 279255; fax: +44 1895 256509.


  Abstract

A 33-year-old man presented with an acute myocardial infarction (MI) after a recent long-haul flight. Angiography revealed thrombus in the right and circumflex coronary artery but no underlying atherosclerosis. Echocardiography revealed the presence of an atrial septal defect (ASD). In view of the recent flight, the presence of an ASD and occlusive thrombi in two coronary arteries, it was considered that the pathophysiological cause was paradoxical embolisation. Transcutaneous device closure of the ASD was implemented to prevent further catastrophic paradoxical embolic events.

Keywords: Paradoxical embolism; Myocardial infarction; Atrial septal defect; Airline flight


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