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The Importance of CT Angiography in Detecting Impending Paradoxical Embolism in Patients With Pulmonary Embolism
Yoshito Yamazaki1, Yoshiro Tanaka1, Goki Uno1
1Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Background:
Impending paradoxical embolism (IPDE) is a rare and life-threatening condition associated with pulmonary embolism (PE). CT angiography (CTA) allows adequate visualization of PE and right ventricular dilatation; however, the usefulness of CTA in detecting IPDE remains unknown.
Case Summary:
We report the case of a patient with IPDE confirmed with CTA after admission. He was successfully treated with surgical thrombectomy and direct closure of the patent foramen ovale (PFO).
Discussion:
We highlight the importance of careful and early investigation of underlying IPDE with the use of CTA in patients with PE.
Take-Home Messages:
CTA is a useful imaging modality for detecting IPDE even when transthoracic echocardiography cannot detect it. Surgical thrombectomy and direct closure of the PFO may be useful strategies to prevent further major thromboembolisms in cases with a high risk of embolism.
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