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Results for “Embolism, Paradoxical”

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At least 19 recordsLinked to original sources
PubMedDate not supplied

Lung scan in the diagnosis and management of patent foramen ovale pulmonary embolism, paradoxical embolism.

This case illustrates the reopening of foramen ovale in a young patient with chronic pulmonary hypertension caused by bronchiectasis and chronic pulmonary fibrosis, which resulted in a prominent right-to-left shunt and severe hypoxia. Her clinically unsuspected right-to-left shunt was discovered during ventilation-perfusion scan, which was performed for the evaluation of pulmonary embolism. She had common variable immune deficiency, a primary immunodeficiency disease in which B-lymphocytes produce few or no antibodies. Most patients with this syndrome have an intrinsic defect in their B-lymphocytes that results in reduced immunoglobulin production. In these patients, recurrent respiratory tract infections are common and may result in chronic lung disease, fibrosis, particularly bronchiectasis (20-30%) and even cor pulmonale as happened in our patient [J. Clin. Immunol. 9 (1989) 22-33.].

Adult↗
PubMed1999

Bilateral renal infarction secondary to paradoxical embolism.

Paradoxical embolism is an uncommon but increasingly reported cause of arterial embolic events. Involvement of the kidney is rarely reported. Autopsy studies suggest, however, that embolic renal infarction is underdiagnosed antemortem. We report a case of bilateral, main renal artery occlusion and acute renal failure secondary to paradoxical embolism. Clinical and laboratory data at presentation were not suggestive of renal infarction. Support for the diagnosis of paradoxical embolism, which most commonly occurs across a patent foramen ovale, was made by contrast echocardiography, which provides a sensitive method for detecting right-to-left intracardiac shunts. The often subtle presentation of renal infarction suggests patients with peripheral or central arterial embolic events should be carefully observed for occult renal involvement. Contrast echocardiography should be performed when renal infarction occurs without a clear embolic source to evaluate for paradoxical embolism.

Acute Kidney Injury↗
PubMed2006

Acute leriche syndrome due to paradoxical embolism.

Paradoxical embolism, describing the passage of venous or right-sided cardiac thrombus into the arterial or systemic circulation through patent foramen ovale, is an uncommon cause of acute arterial occlusion. Here, we report acute Leriche syndrome in a young woman attributable to paradoxical embolism. Ischaemia, patent foramen ovale, and venous thrombosis were the triad of evidence for paradoxical embolism.

Acute Disease↗
PubMed2002

Thrombus-in-transit and paradoxical embolism.

Paradoxical embolism is an uncommon but clinically important phenomenon. Elements of diagnosis include the presence of: (1) a venous thrombus, (2) an arterial embolus, (3) a communication between the right and left heart, and (4) a thrombus traversing such a communication. Unfortunately, all of these elements can be rarely demonstrated in each case but the probability should be considered in any patient with 2 or more present. It should be suspected in patients who have evidence of systemic arterial emboli without apparent cause. A transesophageal echocardiogram with contrast should be considered in cases where paradoxical embolism is a possibility. We present a case in which a "thrombus-in-transit" was imaged across the interatrial septum in a patient with a patent foramen ovale, deep venous thrombosis, and an embolic cerebrovascular stroke.

Aged↗
PubMedDate not supplied

Continuous monitoring by biplane transesophageal echocardiography of pulmonary and paradoxical embolism.

Paradoxical embolism is considered a relatively uncommon disease. Continuous biplane transesophageal echocardiography (TEE) was performed in a 64-year-old woman who had an acute pulmonary embolism. TEE showed an elongated formation highly mobile within both atria. It was trapped in the interatrial septum, passing through a patent foramen ovale. Systemic embolism of the right arm was noted. The patient died 5 hours after admission, and postmortem examination confirmed the diagnosis of pulmonary embolism. This case demonstrates the potential utility of TEE in the study of patients with suspected paradoxical embolism.

Echocardiography, Transesophageal↗
PubMed1990

[Pulmonary embolism and paradoxical embolism in a patient with chronic respiratory insufficiency treated with mechanical ventilation].

The authors report a case of paradoxical embolism associated with pulmonary embolism in a male patient under mechanical ventilation for chronic respiratory failure. They review the present diagnostic criteria of paradoxical embolism and insist on the determinant contribution of contrast echocardiography to the diagnosis. They also discuss the factors which make this type of patient liable to reopening of the foramen ovale and to paradoxical embolism. The clinical and gasometric characteristics of pulmonary embolism occurring in patients under mechanical ventilation are detailed.

Blood Gas Analysis↗
PubMedDate not supplied

Paradoxical embolism.

Paradoxical embolization of venous thrombus into the abdominal aortic bifurcation has been diagnosed by means of aortography. Lower limb phlebothrombosis accounting for the embolus formation has been demonstrated by phlebography. Arterial embolectomy and venous thrombectomy were successfully performed. Recovery was complete without sequelae.

Adult↗
PubMed1998

The role of thrombolytic therapy in the management of paradoxical embolism.

Paradoxical emboli are considered a rare event, representing less than 2% of all arterial emboli. The most common intracardiac defect associated with paradoxical emboli is a patent foramen ovale. Most commonly, a pulmonary embolism is the cause of the acute increase in right atrial pressure leading to a reversal of intracardiac flow and passage of venous embolic material to the left heart. We present a patient with a pulmonary embolism and paradoxical emboli, and discuss therapeutic approach. We suggest that the treatment of choice for the patient with pulmonary embolism and non-limb-threatening acute ischemia due to a paradoxical emboli should be thrombolytic therapy and intracaval filter placement, followed by patent foramen ovale repair.

Aged↗
PubMed1989

Right heart dysfunction, pulmonary embolism, and paradoxical embolization during liver transplantation. A transesophageal two-dimensional echocardiographic study.

In 16 adult patients, we performed continuous intraoperative two-dimensional transesophageal echocardiography (2DTEE) to help elucidate the mechanism of myocardial dysfunction that accompanies liver transplantation. In 4 of the 16 patients "paradoxical" motion of the interventricular septum consistent with right ventricular failure was seen. An additional three of the 16 patients showed right atrial enlargement and right-to-left deviation of the interatrial septum. Two patients showed evidence of paradoxical embolization (one of whom had right ventricular and right atrial enlargement), and a third patient (who had right atrial enlargement) embolized a large right atrial thrombus into the pulmonary circulation. Two-dimensional transesophageal echocardiography demonstrated that isolated right ventricular failure might account for some of the hemodynamic instability seen during liver transplantation. Venous, pulmonary, and paradoxical embolization of air and thrombi documented by transesophageal echocardiography likely contribute to right heart failure.

Adolescent↗
PubMed1997

Prevention of stroke recurrence with presumed paradoxical embolism.

Paradoxical cerebral embolism (PCE) through a patent foramen ovale (PFO) should be considered as a cause of ischemic stroke, particularly in young patients without an alternative cause for stroke. PCE is even more important that it is potentially treatable. However, PCE remains often presumed because it rests upon the rarely demonstrated findings of a deep venous thrombosis and a thrombus lodged in the PFO. Recent studies have shown a rather low stroke recurrence rate in patients with PFO and stroke but suggest that some subgroups of patients with a higher stroke recurrence risk-exist according clinical, echocardiographical and radiological characteristics. For these subgroups, it seems that a more invasive treatment should be required. There are four therapeutic options; antiaggregants, anticoagulation, transcatheter closure of PFO, and surgical closure of PFO. However, these treatments have yet to be evaluated in clinical trials.

Cerebrovascular Disorders↗
PubMed1993

[Transvenous catheter occlusion of the patent foramen ovale in paradoxical embolism].

Paradoxical emboli are assumed to be one cause for cerebral strokes of unknown etiology. These emboli usually cross from the right to the left heart via a patent foramen ovale. We describe the transvenous catheter occlusion as an alternative to surgical closure. There were no complications. The echocardiographic follow-up of 12 and 14 months demonstrated complete closure of the foramen ovale without recurrence of neurologic symptoms.

Adult↗
PubMed2005

Submassive pulmonary embolism and paradoxical embolic stroke treated with percutaneous rheolytic thrombectomy and closure of the patent foramen ovale.

The presence of patent foramen ovale (PFO) in patients with large pulmonary emboli (PE) is associated with an increased risk of stroke and mortality. Many patients are ineligible to receive thrombolytic therapy. We present a patient with bilateral PE and cryptogenic stroke who was treated effectively with rheolytic thrombectomy with AngioJet, PFO closure with CardioSeal device, and placement of an inferior vena cava filter.

Aged↗
PubMed1997

Paradoxical embolism and aortic occlusion: a case report.

This is the case report of a 45-year-old woman who sustained a left popliteal artery embolism. Ten days after popliteal embolectomy, she developed sudden occlusion of the distal aorta. She required a bifemoral embolectomy. Transesophageal echocardiogram demonstrated an atrial septal aneurysm and a septal defect with a right to left shunt. A venogram showed deep venous thrombosis in the right leg as the potential source of the embolism. Paradoxical embolization should be considered when ever an unexplained arterial occlusion occurs, especially in younger patients.

Acute Disease↗
PubMed1995

[Aneurysm of the interatrial septum with atrial septal defect, disclosed by pulmonary embolism complicated by paradoxical embolism].

The authors report the case of a patient admitted to hospital for bilateral phlebitis of the lower limbs, associated with an atrial septal defect. The presence of significant pulmonary hypertension accounted for the paradoxical embolism by inversion of the intracardiac shunt. No recurrence has been observed with a follow-up of six months on anticoagulant treatment.

Embolism↗