title: Intracardiac thrombosis in multiple chambers and descending aorta manifested as systemic and pulmonary thromboembolism.
abstract: We report a case with multiple thrombosis that underwent sudden circulatory collapse due to acute pulmonary embolism and ischemic stroke. Further confirmed by transesophageal echocardiography, the thrombus in both atria was detected by transthoracic echocardiography. In addition, patent foramen ovale and another thrombus in the descending aorta were readily identified by transesophageal echocardiography. Aspirin was prescribed and thrombi disappeared 1 month later. Our case report suggests that patients undergoing sudden collapse with unexplained hypoxemia and new neurological deficit secondary to coexistence of pulmonary and systemic embolism should be promptly evaluated by echocardiography, especially transesophageal one, with high suspicion for paradoxical embolism.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, National Cheng-Kung University Medical Center, Tainan, Taiwan. cool.hsu@msa.hinet.net
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Hsu
authors.forename: Ting-Hsing
authors.initials: TH
authors.lastname: Chao
authors.forename: Wei-Chuan
authors.initials: WC
authors.lastname: Tsai
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Li
authors.forename: Ping-Yen
authors.initials: PY
authors.lastname: Liu
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Lin
authors.forename: Jyh-Hong
authors.initials: JH
authors.lastname: Chen
authors.forename: Liang-Miin
authors.initials: LM
authors.lastname: Tsai
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D013927:Thrombosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography