Thrombus entrapped in a patent foramen ovale: a potential source of pulmonary and systemic embolism.
Patent foramen ovale (PFO) occurs in up to 30% of the population, making it the most common site for intra-cardiac shunting. The passage of thrombus across a PFO is typically transient, thus is rarely proven. We describe a rare case of a 79-year-old man with thrombus entrapped across a PFO providing a source for ongoing pulmonary and systemic thromboembolism, despite systemic anticoagulation. There is a paucity of literature to guide primary management of this condition. Management options include surgical thrombectomy with PFO closure, thrombolysis and systemic anticoagulation. The role of percutaneous PFO closure devices for secondary prevention of thromboembolic complications is currently under investigation.
Kearney
Leighton G
LG
Department of Cardiology, Austin Health, Level 5 North Austin Tower, 145 Studley Road, Heidelberg, Victoria 3084, Australia. leighton.kearney@austin.org.au
Srivastava
Piyush M
PM
D000368:Aged; D000792:Angiography / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D020517:Atrial Appendage / Q000473:pathology; D001281:Atrial Fibrillation / Q000209:etiology; D054087:Atrial Septum / Q000000981:diagnostic imaging / Q000473:pathology*; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D017809:Fatal Outcome; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006322:Heart Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology; D012770:Shock, Cardiogenic / Q000209:etiology; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
D000925:Anticoagulants; D049994:Sodium Potassium Chloride Symporter Inhibitors; D006493:Heparin