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Patent Foramen Ovale with a Straddling Thrombus
Yehia Saleh1,2, Ola Abdelkarim1,2, Samarth Thakkar2,3
1University of Iowa, Iowa City, Iowa, US.
Methodist Debakey Cardiovascular Journal
|February 24, 2025
Summary
A large blood clot was found straddling the heart's patent foramen ovale, causing severe biventricular dysfunction and symptoms like shortness of breath.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Diagnostic Imaging
Background:
- Elderly patients can present with complex cardiac conditions.
- Shortness of breath and edema are common symptoms requiring thorough investigation.
- Patent Foramen Ovale (PFO) is a potential pathway for thromboembolic events.
Purpose of the Study:
- To report a rare case of a large intracardiac clot associated with a PFO.
- To highlight the diagnostic utility of echocardiography in identifying complex cardiac masses.
- To discuss the clinical implications of such findings in elderly patients.
Main Methods:
- Case presentation of a 78-year-old male patient.
- Diagnostic imaging utilizing echocardiography.
- Clinical assessment of symptoms including shortness of breath and lower limb edema.
Main Results:
- Echocardiogram revealed severely decreased biventricular function.
- A large clot was identified straddling the patent foramen ovale.
- The clot extended from the right atrium into the left atrium and ventricle.
Conclusions:
- Intracardiac thrombus formation with PFO involvement can lead to significant hemodynamic compromise.
- Echocardiography is crucial for diagnosing large intracardiac clots and assessing cardiac function.
- Prompt recognition and management are essential in patients with complex cardiac presentations.
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