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European Heart Journal 1994 15(9):1284-1285;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Impending paradoxical embolism: A case report and literature review

M. HARGREAVES, D. MALONEY, B. GRIBBIN and S. WESTABY

Departments of Cardiology, and Cardiothoracic Surgery, John Radcliffe Hospital Headington, Oxford 0X3 9DU, U.K

Received 26 October 1993; revised 16 March 1994; .

Correspondence. Dr M. R. Hargreaves, Cardiac Department, John Radcliffe Hospital, Headington, Oxford OX3 9DU, U.K.

Abstract

Paradoxical embolism occurs following the passage of embolic material from the venous to the arterial circulation through a right to left shunt—frequently a patent foramen ovale. The diagnosis is usually presumptive when arterial emboli occur in the appropriate clinical setting. We describe a case of impending paradoxical embolism in a patient with massive pulmonary embolism. Transoesophageal echocardiography revealed a thromboembolus straddling a patent foramen ovale. The patient underwent emergency removal of the intracardiac clot with closure of the patent foramen ovale.

Key Words: Paradoxical embolism • patent foramen ovale • echocardiography • pulmonary embolectomy


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