Pulmonary embolism and patent foramen ovale thrombosis: the key role of TEE.
This is a case report of a 35 young man with Klinefelter Syndrome presented breathlessness, palpitations and chest pain. It shows a rare case of a thrombus located through the PFO, in patient with pulmonary and paradoxical embolism, which takes back to exciting hypothesis on thrombus growth. A thrombus, which has grown 'in situ' or trapped through the patent foramen ovale, may be a cause of relapsing pulmonary or systemic embolism during anticoagulation therapy. To prevent recurrent paradoxical embolism, percutaneous closure of PFO is recommended, but in this case, thrombus was trapped through the PFO and the patient was referred to the surgeon. We believe that under these circumstances the clinician should be informed of the presence of PFO in critical pulmonary embolism; this case points out the key role of TEE to face a diagnostic and therapeutic scenarios.
Serra
Walter
W
Heart department, Cardiology division, Azienda Ospedaliera/Universitaria Parma, Italy. wserra@libero.it
De Iaco
Giuseppe
G
Reverberi
Claudio
C
Gherli
Tiziano
T
D017548:Echocardiography, Transesophageal / Q000379:methods*; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging*; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*
Chest. 1993 May;103(5):1553-9
8486043
N Engl J Med. 1988 May 5;318(18):1148-52
3362165
Am J Cardiol. 1991 Dec 15;68(17):1723-4
1746481
Circulation. 2001 Apr 10;103(14):1928
11294814
Crit Care Med. 2002 Aug;30(8):1902-5
12163814