[Paradoxical embolisms after pulmonary embolism. 6 cases].
Among a series of 6 patients who had paradoxical emboli after pulmonary embolus, thrombus was encrusted in the foramen ovale in 2 while contrast echocardiography showed a free foramen ovale in the 4 others. Surgical embolectomy was performed in 1 of the patients with a thrombus in the foramen ovale. This patient died in the post-operative period and the second patient died suddenly before the indication for surgery had been established. The 4 other patients were treated medically with anticoagulant therapy. After a follow-up of 37, 33, 32 and 3 months respectively none of these patients has developed recurrent emboli. The association of a thromboembolic disease and a systemic ischaemic event should strongly suggest the diagnosis of paradoxical embolus. Echocardiography is required to determine whether the foramen ovale is free or harbours a thrombus.
Adam
M C
MC
Service de Cardiologie, Centre Hospitalier, Beauvais.
Tribouilloy
C
C
Mirode
A
A
Rey
J L
JL
Bickert
P
P
Lesbre
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000601:surgery; D013997:Time Factors
D000925:Anticoagulants
Embolies paradoxales au décours d'une embolie pulmonaire. 6 observations.