title: Thrombus in the right atrial appendage during pulmonary and paradoxical embolism: a case report.
abstract: We report the case of a 56-year-old woman who was admitted because of left pulmonary embolism. An episode of ischemic stroke occurred during hospitalization. Transesophageal echocardiography revealed a right atrial appendage thrombus and a patent foramen ovale with right to left shunting. This suggested paradoxical embolism across a patent foramen ovale as the most reasonable explanation of the ischemic stroke in this patient, in the presence of right cardiac overload secondary to the hemodynamically significant pulmonary embolism. The patient's clinical conditions dramatically improved after anticoagulant therapy.
authors.affiliation: S. Maria degli Angeli Hospital, ARC, Pordenone, Italy. cardiologia@aopn.fvg.it
authors.forename: Guoqian
authors.initials: G
authors.lastname: Huang
authors.forename: Daniela
authors.initials: D
authors.lastname: Pavan
authors.forename: Francesco
authors.initials: F
authors.lastname: Antonini-Canterin
authors.forename: Rita
authors.initials: R
authors.lastname: Piazza
authors.forename: Matteo
authors.initials: M
authors.lastname: Cassin
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Nicolosi
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000000981:diagnostic imaging* / Q000473:pathology; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D020521:Stroke / Q000209:etiology*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin