Paradoxical embolism of stroke-related patent foramen ovale in a nonagenarian woman
| Autor: | Shinobu Hosokawa, Hiroya Takafuji, Riyo Ogura, Tomoko Izumi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
patent foramen ovale Deep vein Old age Case Report 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Paradoxical embolism Internal medicine Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Thrombus Stroke business.industry Cerebral infarction paradoxical embolism medicine.disease Eustachian Valve Stenosis medicine.anatomical_structure cardiovascular system Cardiology Patent foramen ovale Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular Echography |
| ISSN: | 2211-4122 |
| Popis: | There are few clinical reports of elderly patients with paradoxical embolism in the current literature. Herein, we describe the case of a nonagenarian patient with paradoxical embolism of stroke-related patent foramen ovale (PFO). A 95-year-old woman was admitted to our hospital because of dysarthria. Her medical history included cerebral infarction, hypertension, and dyslipidemia. Magnetic resonance imaging performed in the emergency room revealed cerebral infarction of the left temporal lobe. After hospitalization in the neurosurgery department, we performed further clinical investigations to diagnose the type of stroke. There was no significant stenosis with plaque of the carotid and cerebral arteries, and there were no sources of cardiac embolism or an episode of atrial arrhythmia. Transesophageal echocardiography (TEE) showed PFO with separation and the Eustachian valve. In addition, spontaneous bidirectional shunt flow through the PFO was detected by TEE with the patient at rest. Ultrasonography of the leg vein revealed a thrombus in the deep vein. Therefore, she was diagnosed as having paradoxical embolism of stroke-related PFO and prescribed a direct oral anticoagulant (DOAC). This very rare case in which stroke-related PFO was diagnosed in a nonagenarian patient demonstrates that PFO is the cause of paradoxical embolism of stroke regardless of age. |
| Databáze: | OpenAIRE |
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