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Case report
Cardiac arrest in a healthy child due to paradoxical embolus across a previously unrecognised sinus venosus defect
  1. Margaret M Samyn1,2,
  2. Todd M Gudausky1,2,
  3. Joshua R Kovach1,2 and
  4. Ronald K Woods2,3
  1. 1 Department of Pediatrics, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
  2. 2 Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
  3. 3 Department of Surgery, Division of Pediatric Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
  1. Correspondence to Dr Margaret M Samyn; msamyn{at}


A previously healthy, preadolescent female suffered an unwitnessed cardiac arrest with prompt return of circulation following bystander initiated resuscitation. Workup demonstrated the cause of her cardiac arrest to be distal left anterior descending coronary artery occlusion with small apical left ventricular transmural myocardial infarction, from a paradoxical embolus traversing a previously undiagnosed large sinus venous defect. This case demonstrates the value of cardiac magnetic resonance imaging may bring to the diagnosis of the pathophysiology leading to cardiac arrest.

  • medical management
  • cardiothoracic surgery
  • congenital disorders
  • cardiovascular medicine

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  • Contributors MMS is the specialist in non-invasive cardiac imaging, who performed the cardiac magnetic resonance scan, which was instrumental in this patient’s diagnosis. She conceived of this case report, did the literature search, and wrote the first draft of the manuscript, editing it with the other authors’ suggestions. MMS prepared the revision and shared with other authors for comments. TMG is the interventional cardiologist who performed the cardiac catheterisation and edited this manuscript. JRK is the electrophysiologist who cared for this patient. He obtained patient assent and gaurdian consent for this case report and edited this manuscript with attention to the electrophysiologic aspects of this case. RKW is the cardiothoracic surgeon who operated on this patient. He reviewed this case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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