Konala Venu Madhav, Naramala Srikanth, Adapa Sreedhar, Aeddula Narothama Reddy, Bose Subhasish
Internal Medicine / Hematology and Oncology, Ashland Bellefonte Cancer Center, Ashland, USA.
Rheumatology, Adventist Medical Center, Hanford, USA.
Cureus. 2019 Sep 4;11(9):e5567. doi: 10.7759/cureus.5567.
Controversies exist regarding the treatment of acute massive pulmonary embolism (PE) with anticoagulation alone or with thrombolytic therapy. Paradoxical embolism in the presence of a patent foramen ovale (PFO) is a rare but well-known entity and should always be looked for in case of a PE associated with systemic thromboembolism. We report a case of acute sub-massive PE treated with thrombolytic therapy in an elderly gentleman who had a paradoxical embolism and ischemic stroke as a result of a clot traversing through a PFO. We discussed diagnostic modalities, treatment of choice, and associated controversies in management.
关于单纯抗凝治疗还是溶栓治疗急性大面积肺栓塞（PE）存在争议。卵圆孔未闭（PFO）情况下的反常栓塞是一种罕见但广为人知的情况，在伴有系统性血栓栓塞的PE病例中应始终予以排查。我们报告了一例老年男性急性次大面积PE病例，该患者因血栓穿过PFO导致反常栓塞和缺血性中风，接受了溶栓治疗。我们讨论了诊断方法、治疗选择以及管理中的相关争议。
