Giant thrombus trapped in foramen ovale with pulmonary embolus and stroke.
We describe the case of a young man who, while he was in coma because of a traffic accident, had first a pulmonary embolus and immediately afterwards had a systemic (cerebral) embolus. A transesophageal echocardiographic image revealed a giant thrombi trapped in foramen ovale protruding in right and left ventricles, diagnosing, thus, a paradoxical embolism. The relationship between patent foramen ovale and pulmonary embolism has been reported in some series. Elevated right-chamber pressure caused by pulmonary hypertension could favor the establishment of a right-to-left shunt, causing, in some cases, paradoxical embolisms. We review the clinical implications.
Hospital Universitari Germans Trias i Pujol, Division of Cardiology, Badalona, Spain.
Eduard
E
Claver
Eduardo
E
Larrousse
Eva
E
Bernal
Jorge
J
López-Ayerbe
Vicente
V
Valle
D000063:Accidents, Traffic; D000328:Adult; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging* / Q000209:etiology*; D006346:Heart Septum; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology; D008297:Male; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology; D020521:Stroke / Q000209:etiology