Coronary embolism, as a cause for myocardial infarction, has probably been diagnosed clinically only three or four times.1 Small coronary emboli are usually of little clinical significance and are not infrequently seen at autopsy in cases of bacterial endocarditis2 and in some forms of verrucous endocarditis (verrucal endocardiosis).3 Emboli large enough to produce gross myocardial damage have been reported convincingly in only about 50 cases.1 The literature on this subject has been reviewed several times in recent years.4 The emboli reported have almost always been blood clots which have arisen either from lesions within the coronary arteries, aorta, or endocardium or from the lower extremities by way of a patent foramen ovale. There are only two reports of nonthrombotic emboli. These included a calcified nodule arising from the aortic valve4b and a caseous plug arising from the lungs in a case of pulmonary tuberculosis.
Boas NF, Barnett RN. CORONARY EMBOLISM WITH MYOCARDIAL INFARCTION—COMPLICATION OF VERRUCOUS ENDOCARDITIS. JAMA. 1959;170(15):1804–1808. doi:10.1001/jama.1959.63010150003012a
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