Palacios Martínez J, Ga-Cosío Mir F, Penas Lado M, Oria Vidal J, Garzón Martín A, Solozábal Pastor J
Arch Inst Cardiol Mex. 1979 Jul-Aug;49(4):703-10.
Paradoxical systemic embolism in the absence of congenital heart disease is often considered a clinical or pathologic rarity. We have recently observed two cases of paradoxical systemic emboli, secondary to massive pulmonary embolization in the presence of a patient foramen ovale in an otherwise normal heart. One case was lethal and the diagnosis was confirmed at autopsy. The other case was diagnosed by cardiac catheterization with dye dilution curves and the patient recovered after recurrences were prevented by the placement of an inferior vena cava umbrella-filter. Paradoxical embolization should be suspected when systemic emboli occur without an apparent cause. The diagnosis can be established by cardiac catheterization, pulmonary angiography and phlebography, and recurrences can be prevented by anticoagulation and partial interruption of the inferior vena cava, when the emboli arise from its territory.
在无先天性心脏病的情况下发生反常性体循环栓塞通常被认为在临床或病理上较为罕见。我们最近观察到两例反常性体循环栓子病例，继发于一名心脏正常但存在卵圆孔未闭的患者发生的大量肺栓塞。其中一例是致命性的，尸检确诊了诊断。另一例通过心脏导管检查及染料稀释曲线确诊，患者在放置下腔静脉伞形滤器防止复发后康复。当出现无明显原因的体循环栓塞时，应怀疑反常性栓塞。诊断可通过心脏导管检查、肺血管造影和静脉造影来确立，当栓子源于下腔静脉区域时，抗凝及部分阻断下腔静脉可预防复发。
