Abstract
Introduction: Essential thrombocytosis (Et) is a myeloproliferative disorder with higher incidence of thrombotic events. to our knowledge, we present the first case of st-segment elevation myocardial infarction (stEMI) secondary to paradoxical right coronary artery (rcA) embolus through a patent foramen ovale (PFO) in a patient with essential thrombocytosis and pulmonary embolus. case report: A 67-year old female with a history of Et presented to the emergency room with dyspnea. Physical examination revealed an elevated JVP, an s1Q3t3 pattern on her presenting EcG, and an elevated D-dimer. V/Q scan showed a high probability for pulmonary embolism as well as unusual evidence of right-to-left cardiac shunting. After starting low molecular weight heparin, she developed new-onset chest
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