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From
STEMI and CVA in Hypercoagulable State with Ostium Secundum Defect
Mohammed Al-Sadawi, Bader Madoukh, Ayman Battisha, Shakil Shaikh, Jonathan Marmur, Fadi Yacoub, Samy I. McFarlane
American Journal of Medical Case Reports
.
2019
, 7(12), 320-324 doi:10.12691/ajmcr-7-12-5
Figure
1.
EKG showed new RBBB and ST-segment elevation in leads V1-V2
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Figure
2.
Cardiac catheterization which revealed anterolateral and apical hypokinesis with Global left ventricular function moderately depressed. Ejection fraction (EF) by contrast ventriculography was 37 %. Coronary circulation revealed proximal left anterior descending (LAD) artery 100 % occlusion with completely normal rest of coronary circulation which may indicate embolic lesion. He was treated with drug-eluting stent in LAD with 1 % residual stenosis
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Figure
3
.
Transthoracic echocardiography at the day of PCI revealed EF of 30-35%, severe hypokinesis of the anterior, mid-distal, anteroseptal, and apical wall(s), and systolic and diastolic flattening of ventricular septum which may indicate right ventricular (RV) volume and/ pressure overload. RV was moderately to markedly dilated and atrial septum showed prominent Doppler flow noted at the mid-upper septum suggestive of an atrial septal defect
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Figure 4.
Transesophageal echocardiography which revealed large secundum septal defect measuring 20 mm with left to right flow
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Figure
5
.
MRI brain revealed tiny focus of restricted diffusion left posterior parietal lobe on the Diffusion-weighted magnetic resonance imaging (DWI) series, which may represent a small area of acute or subacute ischemia; and anterior portion of superior sagittal sinus appears thinned and irregular, which may represent partial thrombosis
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