Prevalence of patent foramen ovale in patients with acute myocardial infarction and angiographically normal coronary arteries

Abstract

Acute myocardial infarction (AMI) in the absence of coronary artery disease has been demonstrated in a proportion of presenting cases ranging from <1%1 to 6%.2 Studies in which young stroke victims were examined have shown that there is a significantly higher proportion of these young persons who possess a patent foramen ovale (PFO)3–5 than patients without stroke. The researchers involved in these studies postulate that right to left shunting occurs during a transient reversal of the normal interatrial pressure gradient. In the presence of right-sided thrombus, this could result in paradoxical cerebral embolism. Similarly, if such an embolus were to find its way into a coronary artery, occlusion and infarction could result.5,6 The present study examined patients with AMI who had little or no coronary artery disease in an effort to determine if the frequency of PFO was higher than in the general population.