Paradoxical embolism after amputation in a newly diagnosed diabetic

Paradoxical embolism is rare, but it should be considered in cases of (1) postoperative arterial or cerebral embolism, (2) pulmonary embolism accompanied by systemic arterial or cerebral embolism, (3) systemic arterial or cerebral embolism in patients with a known right-to-left shunt or pulmonary arteriovenous malformation, and (4) systemic or cerebral embolism when no cardiac source can be found. Prognosis depends on both the extent of embolization and the clinical condition of the patient before and during treatment.