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Updated: Sep 16, 2025
10:52
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
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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.
JACC. Case Reports
|July 11, 2025
Summary
Patent foramen ovale (PFO) can lead to paradoxical embolism, causing splenic infarction. This case highlights the importance of considering PFO screening in patients with venous thrombosis and unexplained embolism.
Area of Science:
- Cardiology
- Vascular Medicine
- Radiology
Background:
- Patent foramen ovale (PFO) is a common cardiac anomaly, often asymptomatic.
- PFO can be a pathway for paradoxical embolism, leading to serious complications.
- Splenic infarction secondary to paradoxical embolism via PFO is a rare clinical presentation.
Purpose of the Study:
- To report a unique case of splenic infarction.
- To illustrate paradoxical embolization through a PFO.
- To discuss the diagnostic and management challenges of thrombus in transit.
Main Methods:
- Case report of a 30-year-old woman.
- Clinical presentation: dyspnea, hemoptysis, abdominal pain.
- Diagnostic workup including imaging for deep vein thrombosis, pulmonary embolism, and PFO.
Main Results:
- Confirmed deep vein thrombosis and pulmonary embolism.
- Demonstrated paradoxical embolization through a PFO.
- Identified splenic infarction as a consequence of embolization.
Conclusions:
- PFO screening is recommended for patients with venous thrombosis and cryptogenic embolism.
- Thrombus in transit through a PFO poses management challenges due to lack of established guidelines.
- This case underscores the diverse and severe manifestations of PFO-associated paradoxical embolism.
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