Multiorgan paradoxical embolism consequent to acute pulmonary thromboembolism with patent foramen ovale: a case reportReportar como inadecuado




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Cases Journal

, 2:8358

First Online: 17 September 2009Received: 19 June 2009Accepted: 17 August 2009DOI: 10.4076-1757-1626-2-8358

Cite this article as: Caretta, G., Robba, D., Bonadei, I. et al. Cases Journal 2009 2: 8358. doi:10.4076-1757-1626-2-8358

Abstract

Paradoxical embolism is defined as a systemic arterial embolism requiring the passage of a venous thrombus into the arterial circulatory system through a right-to-left shunt. It is a relatively rare phenomenon, representing about 2% of all cases of arterial embolism. We report a case of a 79-years-old woman admitted to hospital because of dyspnea and lower left limb pain. CT scan revealed multiple thrombi to kidney, lower limb and superior mesenteric artery during acute pulmonary embolism. Echocardiogram documented a patent foramen ovale with a right-to-left shunt. The patient was treated with thrombolytic therapy and heparin with progressive improvement of symptoms and resolution of pulmonary embolism and peripheral thrombosis. Patent foramen ovale closure was not performed because a life-long anticoagulation therapy was necessary, a tunnel-type patent foramen ovale may increases difficulty in realizing device implantation and there are no clear evidence-based guidelines to date addressing treatment in presence of a patent foramen ovale.

AbbreviationsCTcomputerized tomography

PDEparadoxical embolism

PFOpatent foramen ovale

TEEtransesophageal echocardiography

tPAtissue plasminogen activator.

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Autor: Giorgio Caretta - Debora Robba - Ivano Bonadei - Melissa Teli - Benedetta Fontanella - Enrico Vizzardi - Davide Farina - Ri

Fuente: https://link.springer.com/







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