Paradoxical arterial and pulmonary embolism in a patient with a thrombus between atrial septum and patent foramen ovale

Abstract

We describe a 50-year-old woman with an incident of systemic and pulmonary embolism in whom transoesophageal examination (TEE) with the aid of contrast echocardiography (CE) identified a patent foramen ovale (PFO) with a residual thrombus between atrial septum and PFO valve suggesting paradoxical systemic embolization. The patient was diagnosed as heterozygous for prothrombin G20210A mutation. Control TEE performed after fibrinolysis, 2 months of heparin treatment followed by oral anticoagulation did not show any embolic material within the PFO.

Key Words:

• patent foramen ovale
• paradoxical embolization
• transoesophageal echocardiography
• contrast echocardiography