Intracardiac thrombosis in multiple chambers and descending aorta manifested as systemic and pulmonary thromboembolism.
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.
Hsu
Chih-Hsin
CH
Division of Cardiology, Department of Internal Medicine, National Cheng-Kung University Medical Center, Tainan, Taiwan. cool.hsu@msa.hinet.net
Chao
Ting-Hsing
TH
Tsai
Wei-Chuan
WC
Li
Wei-Ting
WT
Liu
Ping-Yen
PY
Lin
Li-Jen
LJ
Chen
Jyh-Hong
JH
Tsai
Liang-Miin
LM
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