Spontaneous closure of a patent foramen ovale and disappearance of impending paradoxical embolism after fibrinolytic therapy in the course of massive pulmonary embolism.
Our case suggests that a negative transesophageal contrast echocardiographic study during stable hemodynamic conditions does not definitively rule out the possibility of a functional PFO with transient right-to-left shunting in situations of increased right heart pressures. In addition, we confirm that thrombolysis can be considered as an alternative to surgery in high-risk patients with impending paradoxical embolism. The risk-to-benefit ratio of this choice, however, should be individually evaluated.
Zerio
C
C
Division of Cardiology-ARC, Ospedale Civile Pordenone, Italy.
Canterin
F A
FA
Pavan
D
D
Nicolosi
G L
GL
D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D004617:Embolism / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D006493:Heparin; D014568:Urokinase-Type Plasminogen Activator