Impending paradoxical embolism

Henmi, Soichiro; Nakai, Hidekazu; Yamanaka, Katsuhiro; Omura, Atsushi; Inoue, Takeshi; Okada, Kenji

doi:10.1016/j.jccase.2020.11.021

Cited by 1 publication

(1 citation statement)

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“…Despite representing a critical clinical scenario, there’s a scarcity of treatment guidelines and evidence. Available treatment options comprise cardiac surgery, thrombolysis, and anticoagulation, either individually or in combination [ 1 , 13 ]. However, both thrombolysis and anticoagulation entail potential risks, including bleeding, thrombus fragmentation leading to additional embolisms (pulmonary and arterial), and hemodynamic deterioration.…”

Section: Discussionmentioning

confidence: 99%

Successful surgical treatment of impending paradoxical embolism with pulmonary embolism and myocardial infarction

Liu,

Yang,

Sun

et al. 2024

J Cardiothorac Surg

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Background Paradoxical embolism is a rare cause of acute arterial occlusion. This phenomenon arises when embolic material travels from the venous system crosses an abnormal shunt such as patent foramen ovale, atrial septal defects, ventricular septal defects, or pulmonary arteriovenous malformations, into the arterial system. Impending paradoxical embolism refers to the presence of an entrapped thrombus in the patent foramen ovale. Case presentation We report a case of a 68-year-old female patient who presented with an impending paradoxical embolism, alongside both concomitant pulmonary embolism and myocardial infarction with ST-segment elevation. Swiftly addressed through emergency cardiac surgery and systemic anticoagulation, the patient’s condition was effectively treated. Conclusions While the ideal treatment strategy for impending paradoxical embolism remains a topic of debate due to limited and inconclusive evidence, emergent open surgery should be contemplated in patients as it signifies a critical clinical emergency.

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Section: Discussionmentioning

confidence: 99%