Acute myocardial infarction in a child: possible pathogenic role of patent foramen ovale associated with heritable thrombophilia.

Abstract

We report an 8-year-old girl who presented with clinical features of an acute myocardial infarction. The angiographic appearance of the coronary arteries was normal. A thrombophilic state caused by a homozygote genotype for the prothrombin G20210A mutation was detected, and a patent foramen ovale (PFO) with right-to-left shunting after Valsalva maneuver was demonstrated by transesophageal contrast echocardiography. No other embolic source was identified. We suggest that paradoxical embolization through a PFO resulted in a myocardial infarction in this young patient with hereditary thrombophilia. We closed the patient's PFO with a 25-mm PFO occluder. She was anticoagulated with warfarin for 6 months. After 6 months, a contrast echocardiogram showed no evidence of residual atrial shunt. There has been no evident recurrent paradoxical embolization.

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Cite this paper

@article{Carano2004AcuteMI, title={Acute myocardial infarction in a child: possible pathogenic role of patent foramen ovale associated with heritable thrombophilia.}, author={Nicola Carano and Aldo Agnetti and Donald J. Hagler and Bertrand Tchana and Umberto Squarcia and Sergio Bernasconi}, journal={Pediatrics}, year={2004}, volume={114 2}, pages={e255-8} }