Impending Paradoxical Embolism

Ma, Xiaojing; Song, Lan; Yang, Hongping; Xia, Juan; Wu, Chunxia; He, Yafeng

doi:10.1016/j.athoracsur.2019.01.011

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…Cases of impending paradoxical emboli have been described previously [7]. In the present case the same prothrombin G2021 mutation was found in the patient that had been diagnosed in her mother.…”

Section: Discussionsupporting

confidence: 81%

A large right atrial thrombus penetrating through a patent foramen ovale in a patient with Prothrombin G2120 Mutation

Anderson

Boehm

Lange

et al. 2021

Preprint

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The Prothrombin mutation G2021 alone is considered a minor risk factor for thromboembolism, but thromboembolic events are more likely in the presence of additional risk factors. We report on a 44-year-old female with an atrial thrombus causing pulmonary embolism and transiting through a patent foramen ovale. The thrombus was extracted by open heart operation. The patient had a family history for thromboembolic events. Further diagnostic after surgery found the patient positive for the Prothrombin mutation G2021, but not for the Factor V Leiden mutation. After surgery, a permanent oral anticoagulation has been started.

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Section: Discussionsupporting

confidence: 81%

A large right atrial thrombus penetrating through a patent foramen ovale in a patient with Prothrombin G2120 Mutation

Anderson

Boehm

Lange

et al. 2021

Preprint

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show abstract

“…The diagnosis of PDE is mostly presumptive, except for those with evidence of emboli in-transit (called impending PDE) via PFO [ 7 ]. There are three required conditions in the diagnosis: emboli from a venous source, abnormal inter-cardiac communication (atrial septal defect or PFO), and evidence of systemic embolism [ 1 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Concomitant acute myocardial infarction and acute pulmonary embolism caused by paradoxical embolism: a case report

Chen

et al. 2021

BMC Cardiovasc Disord

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Background Due to its low incidence and diverse manifestations, paradoxical embolism (PDE) is still under-reported and is not routinely considered in differential diagnoses. Concomitant acute myocardial infarction (AMI) and acute pulmonary embolism (PE) caused by PDE has rarely been reported. Case presentation A 45-year-old woman presented with acute chest pain and difficulty with breathing. Multiple imaging modules including ECG, echocardiography, emergency cardioangiogram (CAG), and CT angiography of the pulmonary arteries showed acute occlusion of the posterolateral artery and acute PE. After coronary aspiration, no residual stenosis was observed. One month later, a bubble study showed inter-atrial communication via a patent foramen ovale (PFO). The AMI in this patient was finally attributed to PDE via the PFO. PFO closure was performed, and long-term anticoagulation was prescribed to prevent recurrent thromboembolic events. Conclusions PDE via PFO is a rare etiology of AMI, especially in patients with concomitant AMI and PE. Clinicians should be vigilant of this possibility and close the inter-atrial channel for secondary prevention.

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“…We considered options including surgical thrombectomy with PFO closure, percutaneous thrombectomy, thrombolysis, and systemic anticoagulation using heparin. Ma et al reported 2 patients who presented with IPDE and were successfully treated with cardiac surgery and thrombolytic therapy [4] . They commented that surgical intervention may be the optimal treatment for patients with unstable hemodynamics or a straddling thrombus; however, thrombolysis may be used in stable patients, with thrombi adherent to the interatrial septum.…”

Section: Discussionmentioning

confidence: 99%