CTICasesParadoxical Embolism in Transit and Systemic Arterial Occlusion via a Patent Foramen Ovale
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
CT pulmonary angiogram demonstrates large, bilateral pulmonary emboli. Additionally, there is a large, mobile, worm-like filling defect within the ascending aorta that extends into the innominate, right subclavian, and left common carotid arteries, with the latter being almost completely occluded. The patient subsequently developed multiple cerebral infarctions.
Key takeaways
Paradoxical embolization occurs when a venous thrombus bypasses the pulmonary circulation via a right-to-left shunt, most commonly a patent foramen ovale (PFO), and enters the systemic arterial circulation. The PFO often opens or widens due to acutely elevated right-sided heart pressures from a large pulmonary embolism. This can result in devastating systemic arterial occlusion, including strokes.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Cocaine-Associated Cardiomyopathy with Hydrostatic Pulmonary EdemaExposure
- Recurrent Spine Osteosarcoma with Pleural MetastasisNeoplastic
- High-Grade Pleomorphic Chest Wall Sarcoma with Pulmonary MetastasesNeoplastic
- Iatrogenic Pulmonary Artery Perforation and Chest Tube MalpositionIatrogenic
- Methotrexate-Induced Iatrogenic Immunodeficiency-Associated Lymphoproliferative DisorderNeoplastic
- Diffuse Alveolar Hemorrhage secondary to Antiphospholipid Antibody SyndromeAutoimmune
- Acute Pulmonary Embolism and Pulmonary Infarction on MRAVascular
- Digital Radiography Artifacts: Grid Misalignment and BackscatterArtifact
See all cases from June 6, 2014 →