Thrombus straddling a patent foramen ovale, pulmonary embolism and paradoxical embolism: a rare trifecta
| Autor: | Murad Abdelsalam, Rachel S. Dada, Jafar Dada, Yashwant Agrawal |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Images In… Foramen Ovale Patent 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Paradoxical embolism Internal medicine medicine Humans 030212 general & internal medicine Thrombus Stroke Foramen ovale (heart) business.industry Thrombosis General Medicine Middle Aged medicine.disease Pulmonary embolism medicine.anatomical_structure Embolism Cardiology Patent foramen ovale Transthoracic echocardiogram Pulmonary Embolism business Embolism Paradoxical |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2018-227505 |
| Popis: | A 55-year-old male presented to the emergency room after awakening with left facial droop, left-sided weakness and garbled speech. Vitals were significant for hypotension (73/43 mm Hg) and hypothermia (35.3°C). Physical examination was significant for left facial droop, dysarthria, bilateral upper extremity strength 4/5, bilateral lower extremity strength 3/5. Laboratory tests were significant for leucocytosis of 16.9×109/L thou/mcL, lactic acid 2.5 mmol/L, creatinine 3.07 mg/dL and troponin 0.07 ng/mL. Chest X-ray revealed no acute process. Head CT revealed no acute process with old right basal ganglia and right frontal lobe infarcts. Head and neck magnetic resonance angiography (MRA) revealed no blockages or aneurysmal dilatations. Brain MRI revealed three areas of diffusion restriction in left temporal occipital lobe, compatible with acute infarcts. Tissue plasminogen activator was not given since he was outside the window. Stroke work-up was ordered, pancultures were sent, broad-spectrum antibiotics were started, and he was sent to the intensive care unit. Transthoracic echocardiogram (TTE) revealed an … |
| Databáze: | OpenAIRE |
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