Acute ST-elevation myocardial infarction secondary to paradoxical embolism

Acute ST-elevation myocardial infarction (STEMI) is a life threatening condition usually caused by rupture of an atheromatous plaque in the coronary arteries. Other causes, such as septic emboli, cholesterol emboli and cocaine abuse have been reported. We report a case of acute STEMI in a young female without any vascular risk factors due to a presumptive paradoxical embolism via a secundum atrial septal defect (ASD). Young patients without vascular risk factors presenting with acute myocardial infarction should be investigated to exclude an underlying cause of their myocardial infarction, such as a paradoxical embolus.