Department of Pulmonology. Hospital Pulido Valente. Centro Hospitalar Universitário Lisboa Norte. Lisboa. Portugal.
Acta Med Port. 2021 Jun 1;34(6):460-463. doi: 10.20344/amp.12856.
Paradoxical embolism is an uncommon phenomenon, accounting for only 2% of all cases of systemic arterial embolism. This condition suggests the presence of a patent foramen ovale, present in 20% - 25% of the adult population. The authors report the case of a 63-year-old male patient with a history of lung adenocarcinoma and hereditary thrombophilia admitted to hospital with acute onset of dyspnea, diplopia, confusion and decreased motor strength of the right limbs. Cranial computed tomography scan showed acute ischemic injury in the left posterior cerebral artery and computed tomography pulmonary angiography revealed bilateral pulmonary thromboembolism. A transesophageal echocardiogram confirmed the presence of patent foramen ovale. The patient was treated with anticoagulant therapy with progressive clinical improvement. Due to a high risk of recurrent thromboembolic episodes, the percutaneous closure of patent foramen ovale was performed and anticoagulant therapy was maintained indefinitely.
反常栓塞是一种罕见的现象，仅占全身动脉栓塞病例的 2%。这种情况表明卵圆孔未闭的存在，在 20%至 25%的成年人群中存在。作者报告了一例 63 岁男性患者的病例，该患者患有肺腺癌和遗传性血栓形成倾向，因急性呼吸困难、复视、意识混乱和右侧肢体运动力量下降而住院。头颅计算机断层扫描显示左侧大脑后动脉急性缺血性损伤，计算机断层肺动脉造影显示双侧肺血栓栓塞。经食管超声心动图证实卵圆孔未闭的存在。该患者接受抗凝治疗，临床症状逐渐改善。由于复发性血栓栓塞事件的风险较高，进行了卵圆孔未闭的经皮封堵，并无限期维持抗凝治疗。
