title: Paradoxical embolism interrupted.
abstract: A 41 year-old African-American male presented with syncope preceded by shortness of breath at outside facility and transferred to us for management of extensive pulmonary embolism with unstable vital signs. Electrocardiogram showed sinus tachycardia with S1Q3T3 pattern. A transthoracic echocardiogram revealed a freely mobile strand like mass in the left atrium. A transoesophageal echocardiogram showed a very large freely mobile thrombus extending from a patent foramen ovale in to the left atrium. He underwent emergent surgery for the extraction of clot followed by thromboembolectomy from both pulmonary arteries. He made a remarkable recovery and was discharged after seven days of hospital stay.
authors.affiliation: Division of Cardiology, Department of Medicine, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd., Suite 300, Allentown, PA 18103-6381, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Desai
authors.affiliation: Division of Cardiology, Department of Medicine, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd., Suite 300, Allentown, PA 18103-6381, USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Ayub
authors.affiliation: Division of Cardiology, Department of Medicine, Lehigh Valley Health Network, 1250 S Cedar Crest Blvd., Suite 300, Allentown, PA 18103-6381, USA. Electronic address: Matthew_W.Martinez@lvhn.org.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Martinez
mesh_terms: D000328:Adult; D017548:Echocardiography, Transesophageal; D054092:Foramen Ovale, Patent / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013575:Syncope / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013616:Tachycardia, Sinus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017131:Thrombectomy
keywords: Embolectomy; Embolism; Paradoxical; Patent foramen ovale; Pulmonary