Coronary paradoxical embolism in a young patient with patent forame ovale, genetic prothrombotic mutation and heparin hypersensibility

The presence of patent forame ovale portends an increased risk of paradoxical embolism, particularly when atrial septal aneurysm is associated. The classic and most frequent clinical manifestation of paradoxical embo- lism through a patent forame ovale is ischemic stroke, although every vascular district in the systemic circula- tion may be involved. It is known that coagulation abnormalities may further promote embolisms in these patients. In this report we describe a case of coronary paradoxical embolism in a young patients with patent forame ovale and atrial septal aneurysm, prothrombotic state, and previous hypersensitivity reaction to hepa- rin.