A suspected case of paradoxical renal embolism through the patent foramen ovale.
We experienced a case of cryptogenic renal infarction in a previously healthy 60-year-old man. He had no systemic atherosclerotic changes. Holter monitoring revealed no atrial fibrillation. Transthoracic echocardiography showed no thrombus. Because the onset occurred while he was swinging a golf club (a similar maneuver to holding the breath), further examination was performed with a view to detecting paradoxical embolism through the foramen ovale. A positive bubble test with the Valsalva maneuver during transesophageal echocardiography led to the diagnosis of patent foramen ovale (PFO). This was a suspected case of paradoxical embolism through a PFO leading to renal infarction.
Division of Nephrology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
Masaki
M
Iwasaki
Nobuhiko
N
Joki
Yuri
Y
Tanaka
Hidehiko
H
Hara
Makoto
M
Suzuki
Hiroki
H
Hase
D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging / Q000209:etiology*; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014636:Valsalva Maneuver