Related Experiment Video
Updated: Sep 30, 2025
07:44
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
543
Acute neurological deficit with submassive pulmonary emboli
Adam Calthrop1, Asad Shabbir2, Michael Raffles2
1Royal Berkshire NHS Foundation Trust, Reading, UK adam.calthrop@nhs.net.
BMJ Case Reports
|March 16, 2022
Summary
A high-risk pulmonary embolism (PE) case presented with collapse and unresponsiveness despite normal hemodynamics. This was due to a paradoxical embolism through a patent foramen ovale, causing cerebral infarction.
Area of Science:
- Cardiology
- Neurology
- Emergency Medicine
Background:
- Pulmonary embolism (PE) is a common emergency department diagnosis.
- Syncope in PE can indicate impending hemodynamic collapse and increased mortality.
- Neurological deficits in thromboembolic disease can arise from causes beyond cerebral hypoperfusion.
Observation:
- A woman in her 60s presented with high-risk PE features.
- She collapsed and became unresponsive (Glasgow Coma Scale 4/15) despite stable hemodynamics.
- Neurological signs and CT confirmed a large cerebral infarction.
Findings:
- The patient had a large territory cerebral infarction.
- Cardiovascular investigations revealed a grade 4 patent foramen ovale.
- The clinical presentation was attributed to a paradoxical embolism complicating venous thromboembolism.
Implications:
- This case highlights the importance of considering paradoxical embolism in PE patients with neurological deficits.
- Thorough clinical examination and investigation are crucial for diagnosing complex presentations.
- Effective management strategies for venous thromboembolism with paradoxical embolism require further evidence-based discussion.
More Related Videos
09:22Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
12.3K
06:15Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
50.6K
Related Concept Videos
01:29Pulmonary Embolism I: Introduction
109
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...
109
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
60
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...
60
01:27Pulmonary Embolism III: Nursing Management
60
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...
60
01:21Acute Respiratory Failure-II
411
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
411
01:26Pneumothorax-I
496
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
496
01:27Pneumothorax-II
430
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
430