Paradoxical embolism through a patent foramen ovale.

The high prevalence of clinically silent venous thrombosis and the presence of a patent foramen ovale in up to 35% of the general population suggests that paradoxical embolism (PDE) may be the cause of an ischaemic stroke or a peripheral thrombo-embolic occlusion more often than is presently considered. We report an ante-mortem diagnosed case of PDE and a review of the literature. Contrast echocardiography with provocative manoeuvres is suggested as the key investigation for diagnosis and anticoagulation is the mainstay of therapy.