title: Paradoxical embolus caught in transit through a patent foramen ovale.
abstract: Diagnosing a paradoxical embolism is challenging, and it can be proven only if the thrombus is identified across the intracardiac defect. Very few cases have been diagnosed as an impending paradoxical embolism. Recently, the diagnosis and management of these entities have greatly improved with the advent of transesophageal echocardiography (compared with transthoracic echocardiography). Pulmonary hypertension may cause right-to-left shunting across a patent foramen ovale and predispose development of a paradoxical embolism. We report a patient with an impending paradoxical embolism that was caught in transit across the patent foramen ovale. The patient was treated successfully with emergent surgery.
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Dipesh K
authors.initials: DK
authors.lastname: Shah
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ritter
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Sinak
authors.forename: John A
authors.initials: JA
authors.lastname: Miller
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed