[Arterial embolism caused by an intra-aortic thrombus or a patent foramen ovale? Diagnosis by transesophageal echocardiography].
This case report demonstrates the value of transoesophageal echocardiography (TOE) in comparison with transthoracic echocardiography as it allows a better view of the thoracic aorta, the auricles, the interauricular septum and the cardiac valves, especially in the intubated and ventilated patients. A 84-year-old woman was admitted to the ICU for hypoxia after carotid-subclavian bypass surgery for acute ischaemia of the left upper limb. The TOE showed a dilated right heart and a patent foramen ovale, compatible with pulmonary embolism as well as two thrombi in the aortic arch. The patient died on the 8th postoperative day from refractory hypoxia. the autopsy confirmed the pulmonary embolism and the intraaortic thrombi. It is concluded that TOE, readily feasible is indicated in case of hypoxia, shock and systemic embolism without cause immediately recognizable, especially in ventilated patients.
Jeannot
T
T
Service de Réanimation, Hôpital Edouard-Herriot, Lyon.
Védrinne
J M
JM
Xuan
B B
BB
Chevalier
J M
JM
Motin
J
J
D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*
Embolie artérielle par thrombus aortique ou foramen ovale perméable? Diagnostic par échocardiographie transoesophagienne.