Multiple Intracardiac and Paradoxical Thrombi Caused by a Thrombus Entrapped in a Patent Foramen Ovale

Can J Cardiol. 2020 Dec;36(12):1978.e5-1978.e8. doi: 10.1016/j.cjca.2020.08.021. Epub 2020 Sep 2.

Abstract

Patent foramen ovale (PFO) usually represents a benign incidental finding. Occasionally, a PFO can open widely, resulting in paradoxical embolism, with potentially devastating consequence. Floating intracardiac thrombi and thrombus straddling a PFO are 2 extremely rare conditions associated with a dismal prognosis and encountered almost exclusively in the setting of pulmonary embolism (PE). We report the unusual case of a 47-year-old man with an unremarkable medical history who presented with a bilateral PE and multiple paradoxical and intracardiac floating thrombi in the setting of a thrombus entrapped in a PFO.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Cardiac Imaging Techniques / methods
  • Cardiac Surgical Procedures* / instrumentation
  • Cardiac Surgical Procedures* / methods
  • Computed Tomography Angiography / methods
  • Echocardiography / methods
  • Electrocardiography / methods
  • Embolism, Paradoxical* / diagnosis
  • Embolism, Paradoxical* / drug therapy
  • Embolism, Paradoxical* / etiology
  • Fibrinolytic Agents / administration & dosage
  • Foramen Ovale, Patent* / complications
  • Foramen Ovale, Patent* / diagnostic imaging
  • Foramen Ovale, Patent* / physiopathology
  • Foramen Ovale, Patent* / surgery
  • Heparin / administration & dosage*
  • Humans
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / drug therapy
  • Ischemic Attack, Transient / etiology
  • Lung / blood supply
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Preoperative Care / methods
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / drug therapy
  • Pulmonary Embolism* / etiology
  • Septal Occluder Device*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Heparin