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Updated: Sep 16, 2025

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Thrombus in Transit Through Patent Foramen Ovale Causing Splenic Infarction
Rana Rashwan1, Judy Rizk2, Ingy Etman2
1Cardiovascular Department, Mayo Clinic, Rochester, Minnesota, USA; Alexandria Main University Hospital, Alexandria, Egypt.
Background:
Patent foramen ovale (PFO) is often asymptomatic but can cause paradoxical embolism. Although cryptogenic stroke is common, this case is unique due to splenic infarction and a visible thrombus in transit.
Case Summary:
A 30-year-old woman presented with acute dyspnea, hemoptysis, and left upper quadrant abdominal pain. Investigations revealed deep vein thrombosis complicated by pulmonary embolism and paradoxical embolization through PFO, leading to splenic infarction-a rare sequence of events.
Conclusions:
Screening for PFO should be considered in patients with venous thrombosis and cryptogenic embolism. Thrombus in transit through PFO presents a challenge due to the lack of consensus on management.
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