CTICasesParadoxical Embolism via Patent Foramen Ovale
Imaging findings
Chest CT angiography shows pulmonary emboli and a filling defect representing a thrombus straddling a patent foramen ovale in the left atrium. Abdominal CT shows complete occlusion of the superior mesenteric artery by an embolus.
Key takeaways
Paradoxical embolism occurs when a venous thrombus passes through a right-to-left intracardiac shunt into the systemic arterial circulation. Acute pulmonary embolism can raise right heart pressures, opening a latent PFO and facilitating systemic embolization.
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