A 35-year-old male patient was found in cardiac arrest in his vehicle, with no apparent injuries after a minor motor vehicle collision. The decedent was found to have a saddle pulmonary embolus with a thromboembolus impacted across a patent foramen ovale and a paradoxical embolism in the circumflex coronary artery, as well as significant clotting in the deep veins of both lower extremities. There were no risk factors in his history to explain the deep venous thrombosis; family history suggested the possibility of an unrecognized clotting disorder.
Keywords: coronary artery embolism; forensic science; hypercoagulable syndromes; manner of death; paradoxical embolism; patent foramen ovale.
© 2017 American Academy of Forensic Sciences.