Related Experiment Video
Updated: Apr 11, 2026
07:44
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
985
A patient with multiple paradoxical emboli
1Department of Surgery, Division of Vascular Surgery, UConn Health, Farmington, Conn.
Journal of Vascular Surgery
|June 3, 2015
Summary
This case report details a patient with simultaneous pulmonary and paradoxical emboli, leading to stroke and leg ischemia. Treatment involved embolectomy, delayed anticoagulation, and an inferior vena cava filter due to complex risks.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Background:
- Patient presented with multiple risk factors for thromboembolic events, including autoimmune disease, cancer, and recent pelvic surgery.
- Simultaneous pulmonary emboli and paradoxical embolism to the cerebellum were diagnosed, causing stroke and acute limb ischemia.
Observation:
- A patent foramen ovale was suspected and confirmed via echocardiography, facilitating paradoxical embolism.
- The patient underwent emergent left common femoral embolectomy for acute leg ischemia.
Findings:
- Treatment decisions were complicated by the need to balance anticoagulation benefits against the risk of hemorrhagic transformation of the cerebellar stroke.
- Anticoagulation was delayed, and an inferior vena cava filter was placed to manage embolic risk.
Implications:
- This case highlights the diagnostic and therapeutic challenges in managing patients with multiple paradoxical emboli.
- Multidisciplinary management is crucial for optimizing outcomes in complex embolic events.
Related Concept Videos
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
680
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
680
01:29Pulmonary Embolism I: Introduction
1.3K
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
1.3K
01:27Pulmonary Embolism III: Nursing Management
688
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
688
01:30Venous Thrombosis I: Introduction
721
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
721
01:30Venous Thrombosis IV: Nursing Management
392
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
392
01:29Venous Thrombosis III: Interprofessional Care
471
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
471