Islam M A, Khalighi K, Goldstein J E, Raso J
Easton Hospital, PA 18042, USA.
J Emerg Med. 2000 Jul;19(1):31-4. doi: 10.1016/s0736-4679(00)00178-5.
Paradoxical embolism through a patent foramen ovale (PFO) can involve multiple organs simultaneously. The most commonly involved sites are the cerebrum and the extremities. Paradoxical embolism to coronary arteries or upper extremities is relatively uncommon. We report a case of acute pulmonary embolism and paradoxical embolism through a patent foramen ovale involving the left upper extremity, brain, and coronary artery. Early diagnosis in the emergency department was made by a trans-esophageal echocardiogram, and the patient was successfully treated with intravenous t-PA and heparin. Patients with acute pulmonary embolism or deep venous thrombosis who also develop signs of systemic embolism should be evaluated for a patent foramen ovale.
通过卵圆孔未闭（PFO）发生的反常栓塞可同时累及多个器官。最常受累的部位是大脑和四肢。冠状动脉或上肢发生反常栓塞相对少见。我们报告一例通过卵圆孔未闭发生急性肺栓塞及累及左上肢、脑和冠状动脉的反常栓塞病例。在急诊科通过经食管超声心动图做出早期诊断，患者接受静脉注射t-PA和肝素成功治疗。发生急性肺栓塞或深静脉血栓形成且同时出现系统性栓塞体征的患者，应评估是否存在卵圆孔未闭。
