Paradoxical embolism and acute arterial occlusion

Paradoxical embolism, due to passage of emboli through an intracardiac defect is now recognised as a cause of acute arterial embolisation. We present the case of a patient in whom unexplained arterial embolisation was diagnosed before further investigation, including contrast echocardiography, revealed a patent foramen ovale associated with pulmonary embolisation and deep venous thrombosis. This report illustrates the often confusing clinical picture that can accompany this syndrome. Early diagnosis and successful management depends on early clinical recognition and appropriate diagnostic procedures.