1. Pulmonary Embolism and Thrombus in Transit Through Patent Foramen Ovale.
- Author
-
Ieva R, Magnesa M, Gallo N, Cassese M, Di Biase M, and Brunetti ND
- Subjects
- Female, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent surgery, Humans, Middle Aged, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism surgery, Suture Techniques, Thrombectomy, Thromboembolism diagnostic imaging, Thromboembolism surgery, Treatment Outcome, Vena Cava Filters, Venous Thrombosis diagnostic imaging, Venous Thrombosis surgery, Accidental Falls, Foramen Ovale, Patent complications, Pulmonary Embolism etiology, Thromboembolism etiology, Venous Thrombosis etiology
- Abstract
Thrombus-in-transit through a patent foramen ovale (PFO) in a patient with pulmonary embolism (PE) is a rare event with high mortality rates. We report the case a of 53-year-old woman admitted for dyspnea, cough, hemoptysis, presyncope, tachycardia, and hypotension. A recent fall down the stairs with costal trauma was also reported. At transthoracic echocardiography, dilated right atrium with the presence of a large floating thrombus was found, protruding into the left atrium through a PFO; lower extremity vascular ultrasound showed right great saphenous vein thrombosis extended over the saphenofemoral junction up to the common femoral vein. CT scan showed submassive thromboembolism; surgical thrombectomy was, therefore, performed with the closure of the PFO; an inferior vena cava filter was also positioned for the prevention of recurrent episodes of thromboembolism. The patient was discharged in therapy with apixaban 5 mg twice a day. Two-month follow up was uneventful. Large thrombi in transit through PFO can be found at transthoracic echocardiography. The management, either medical or surgical, should be aimed at preventing systemic thromboembolism., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF