Document Detail

Large emboli on their way through the heart - first live demonstration of large paradoxical embolisms through a patent foramen ovale.
MedLine Citation:
PMID:  16520095     Owner:  NLM     Status:  MEDLINE    
We report a case of large paradoxical embolisms through a patent foramen ovale in a patient with acquired heparin-induced thrombocytopenia type II (HIT). One large ventricular thrombus embolizing through the aortic valve was documented on videotape for the first time while performing transesophageal echocardiography. A 56-year-old man was admitted with acute respiratory failure initially believed to have an exacerbated chronic obstructive pulmonary disease. Arterial oxygen saturation was only 33%. He received antibiotic and anti-obstructive treatments and was mechanically ventilated for 7 days. Few hours after extubation, he developed recurrent severe dyspnea accompanied by acute pain and pulselessness in his left leg. Transthoracic echocardiography revealed an enlarged right ventricle and suggested the presence of free-floating thrombi both in the right and in the left-heart cavities. During transesophageal echocardiography, a large serpentine left-heart thrombus embolized through the aortic valve and disappeared. The patient developed ventricular fibrillation and underwent successful cardiopulmonary resuscitation including emergency thrombolysis with alteplase. Four hours later, the surgeon retrieved a 20-cm long thrombus from the left femoral artery.
Lars S Maier; Nils Teucher; Hilmar Dörge; Stavros Konstantinides
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-03-06
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  8     ISSN:  1525-2167     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-01-22     Completed Date:  2007-04-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  158-60     Citation Subset:  IM    
Abt. Kardiologie & Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
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MeSH Terms
Echocardiography, Transesophageal
Embolism, Paradoxical / complications*,  ultrasonography*
Femoral Artery
Heart Septal Defects, Atrial / complications*,  ultrasonography*
Magnetic Resonance Angiography
Middle Aged
Thromboembolism / diagnosis,  surgery
Video Recording*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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