Xiong Chang-ming, Liu Zhi-hong, Cheng Xian-sheng, He Jian-guo, Ni Xin-hai, Zhao Yan-fen, Gao Ying, Chen Bai-ping
Pulmonary Vascular Disease Center, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2006 Mar;29(3):161-3.
To describe the clinical features of paradoxical embolism and therefore to improve its diagnosis.
Case analysis and literature review.
Eight cases of pulmonary embolism complicated with paradoxical embolism were diagnosed, of whom there were six men and two women (mean age, 47.6 years). Patent foramen ovale with right to left shunt was identified in only 3 cases. Cerebral embolism occurred in three patients, kidney artery embolism in 2 patients, left atrial thrombus in 1 patient, lower limb artery and aortic embolism in 1 patients respectively. The diagnosis of paradoxical embolism can only be confirmed when a venous thrombus was detected lodged at arterial-venous communication; otherwise, paradoxical embolism was considered a clinical diagnosis. Of the 8 cases, 7 were clinically diagnosed, while 1 was confirmed.
Paradoxical embolism is not uncommon. The diagnosis should be considered when venous thromboembolism is complicated with systematic embolism or unknown cause of systematic embolism.
