title: Massive pulmonary embolism and acute limb ischaemia in a patient of hereditary spherocytosis and patent foramen ovale.
abstract: Paradoxical embolism accounts for 2% of patients who present with acute arterial embolism of extremities. We report a case of a 41 year-old male with hereditary spherocytosis who presented to the emergency department with acute limb ischaemia and pulmonary embolism. On further evaluation, he was found to have patent foramen ovale (PFO) and deep vein thrombosis (DVT), leading to paradoxical embolism. The purpose of this report is to emphasise that in a patient presenting with acute limb ischaemia without an obvious systemic arterial embolic source, an evaluation for a right-to-left shunting lesion, especially PFO, should be performed.
authors.affiliation: Rashid Hospital, PO Box 4545, Dubai, United Arab Emirates. skacardio@yahoo.com
authors.forename: S K
authors.initials: SK
authors.lastname: Agarwal
authors.forename: A S
authors.initials: AS
authors.lastname: Binbrek
authors.forename: James A
authors.initials: JA
authors.lastname: Thompson
authors.forename: Safia A P
authors.initials: SA
authors.lastname: Siddiqui
mesh_terms: D000328:Adult; D000401:Aircraft; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology*; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D007866:Leg / Q000098:blood supply*; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology*; D013103:Spherocytosis, Hereditary / Q000150:complications*; D014195:Travel