Open AccessParadoxical embolus straddling patent foramen ovale demonstrated by computed tomographic pulmonary angiography
Author(s) -
Laura Cormack,
John T Murchison
Publication year - 2013
Publication title -
world journal of clinical cases
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v1.i3.108
Subject(s) - medicine , patent foramen ovale , radiology , pulmonary angiography , concomitant , computed tomographic , pulmonary embolism , embolus , venous thrombosis , warfarin , cardiology , past medical history , emergency department , thrombosis , surgery , computed tomography , atrial fibrillation , percutaneous , psychiatry
An elderly gentleman presented to the emergency department with a recent history of dyspnoea, collapse and transient neurological symptoms. He was noted to be hypoxic with a significantly elevated D Dimer. A computer tomography pulmonary angiogram demonstrated a large embolus with a further filling defects within the left and the right atria, abutting the inter-atrial septum. Suspicion of a paradoxical pulmonary embolus was raised and the patient subsequently underwent echocardiography which confirmed a patent foramen ovale (PFO). He was commenced on warfarin therapy. In patients with elevated right heart pressure, a PFO can be unmasked and give rise to cerebral emboli. Clinical suspicion should be raised in patients with pulmonary emboli or deep venous thrombosis if there is a concomitant history of focal neurological symptoms.