Simultaneous Acute Pulmonary Embolism and Isolated Septal Myocardial Infarction in a Young Patient

Eur J Case Rep Intern Med. 2016 Aug 24;3(6):000436. doi: 10.12890/2016_000436. eCollection 2016.

Abstract

We report the case of a young patient with a simultaneous isolated septal myocardial infarction (MI) and pulmonary embolism (PE). The aim was to describe a rare clinical entity and to explain why these two pathologies were present at the same time in a young patient. A review of literature was performed. An interventional cardiologist, an interventional radiologist and a lung specialist were consulted. The diagnostic workup revealed only heterozygous Factor Leiden V mutation. This presentation was probably fortuitous, but worth reporting in our opinion.

Learning points: To our knowledge, the simultaneous presentation of an isolated septal MI and PE in a young patient has never been reported.Isolated septal MI should be considered in the presence of right bundle branch block (RBBB) at sub-occlusion of a large septal branch. The final diagnosis can optimally be confirmed by cardiac magnetic resonance (CMR).An increasing number of asymptomatic PE are being detected due to advances in computed tomography (CT) scanning. This is important because, if left untreated, incidental PE may be associated with higher recurrence rate and mortality.

Keywords: Pulmonary embolism; incidental; isolated septal myocardial infarction; myocardial infarction in the young.