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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
A suspected case of paradoxical renal embolism through the patent foramen ovale
Masaki Iwasaki1, Nobuhiko Joki, Yuri Tanaka
1Division of Nephrology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
Abstract:
We experienced a case of cryptogenic renal infarction in a previously healthy 60-year-old man. He had no systemic atherosclerotic changes. Holter monitoring revealed no atrial fibrillation. Transthoracic echocardiography showed no thrombus. Because the onset occurred while he was swinging a golf club (a similar maneuver to holding the breath), further examination was performed with a view to detecting paradoxical embolism through the foramen ovale. A positive bubble test with the Valsalva maneuver during transesophageal echocardiography led to the diagnosis of patent foramen ovale (PFO). This was a suspected case of paradoxical embolism through a PFO leading to renal infarction.
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