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[Impending paradoxical embolism].

Miguel A Veltri1, Marcelo H Perez, Elias D Soloaga

  • 1Servicio de Cuidados Intensivos, Hospital Británico de Buenos Aires. veltrim@intramed.net

Medicina
|January 24, 2007
PubMed
Summary
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Impending paradoxical embolism, a rare but serious complication, occurs when an intracardiac thrombus crosses a patent foramen ovale. This case highlights the catastrophic potential of this thromboembolic event.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Thromboembolic Disease

Background:

  • Paradoxical embolism is a rare complication of thromboembolic disease.
  • A patent foramen ovale (PFO) can allow venous thrombi to enter arterial circulation.
  • Prostatectomy is a potential risk factor for thromboembolic events.

Observation:

  • A 71-year-old male developed bilateral pulmonary embolism post-prostatectomy.
  • Computed tomography (CT) scan confirmed pulmonary embolism.
  • Transesophageal echocardiogram revealed an intracardiac thrombus traversing a PFO into the left atrium.

Findings:

  • The patient presented with impending paradoxical embolism.
  • Anticoagulation with heparin was initiated.
  • Surgical embolectomy was performed due to the critical finding.

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Implications:

  • This case underscores the importance of considering paradoxical embolism in patients with unexplained thromboembolic events, especially after surgery.
  • Early diagnosis and intervention are crucial, though outcomes can be poor.
  • Further research into preventative strategies and management of intracardiac thrombi in PFO is warranted.