Mandorla S, Fronticelli M, Taliani M R
Istituto di Cardiologia, Ospedale Silvestrini, Università degli Studi, Perugia.
G Ital Cardiol. 1997 Jun;27(6):588-92.
We describe a case of pulmonary embolism and ischemic stroke due to paradoxical embolism in a healthy young woman taking oral contraceptives to treat an ovarian cyst. It was not possible to identify the site of the thromboembolus. Ultrasound techniques played an important role in identifying the peripheral arterial obstructions and in diagnosing acute pulmonary hypertension. Transesophageal echocardiography provided detailed information on both the morphology and the evolution of the atrial thrombus straddling the foramen ovale within the aneurysmal interatrial septum. The patient was given anticoagulant treatment, initially with heparin and subsequently with warfarin over a period of six months. Repeated ultrasound controls showed no thrombus, regression of the signs of pulmonary hypertension and, lastly unchanged systemic arterial obstruction.
我们描述了一例健康年轻女性因服用口服避孕药治疗卵巢囊肿而发生矛盾栓塞导致肺栓塞和缺血性卒中的病例。无法确定血栓栓塞的部位。超声技术在识别外周动脉阻塞和诊断急性肺动脉高压方面发挥了重要作用。经食管超声心动图提供了关于位于动脉瘤样房间隔内卵圆孔处的心房血栓的形态和演变的详细信息。患者接受了抗凝治疗，最初使用肝素，随后在六个月内使用华法林。反复超声检查显示无血栓形成，肺动脉高压体征消退，最后全身动脉阻塞无变化。
