2,101 results match your criteria Paradoxical Embolism


Paradoxical embolism as a cause of myocardial infarction in a patient with pulmonary embolism: role of transesophageal echocardiography.

Acta Cardiol 2019 Jan 16:1-2. Epub 2019 Jan 16.

a Université libre de Bruxelles (ULB) , Cardiology Department, CHU Saint-Pierre , Brussels , Belgium.

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http://dx.doi.org/10.1080/00015385.2018.1544682DOI Listing
January 2019

Association of Embolic Sources With Cause-Specific Functional Outcomes Among Adults With Cryptogenic Stroke.

JAMA Netw Open 2018 Sep 7;1(5):e182953. Epub 2018 Sep 7.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Importance: It is unknown whether poststroke outcome varies between different potential causes in patients with cryptogenic stroke.

Objective: To investigate whether functional outcome differs according to potential embolic sources after cryptogenic stroke.

Design, Setting, And Participants: This multicenter, hospital-based, prospective stroke registry cohort study investigated potential embolic sources on admission and assessed 3-month outcome in patients with ischemic stroke hospitalized at 7 stroke centers in the Fukuoka Stroke Registry. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.2953DOI Listing
September 2018
2 Reads

Anticoagulation in patients with Embolic Stroke of Unknown Source.

Authors:
J David Spence

Int J Stroke 2019 Jan 15:1747493019826363. Epub 2019 Jan 15.

Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Canada.

When warfarin was the mainstay of anticoagulation for the prevention of cardioembolic stroke, the paradigm was essentially "we mustn't anticoagulate anyone unless we prove that the stroke was cardioembolic." Now that direct-acting oral anticoagulants are available, the paradigm should change. The risk of stroke is highest soon after the initial event, particularly in patients with more than one infarction. Read More

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http://dx.doi.org/10.1177/1747493019826363DOI Listing
January 2019

Pediatric Acute Paradoxical Cerebral Embolism with Pulmonary Embolism Caused by Extremely Small Patent Foramen Ovale.

Open Med (Wars) 2019 24;14:10-13. Epub 2018 Dec 24.

Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.

Herein, we report a pediatric case of acute paradoxical cerebral embolism complicated by serious acute pulmonary embolism that was caused by an extremely small patent foramen ovale (PFO). The patient had no medical history suggestive of any other reason. Paradoxical cerebral embolism may occur even with an extremely small PFO because of the increased right-side pressure of the heart and a resulting right-to-left shunt from the acute pulmonary embolism. Read More

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http://dx.doi.org/10.1515/med-2019-0002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310914PMC
December 2018

Paradoxical embolism caused by ovarian vein thrombosis extending to inferior vena cava in a female with uterine myoma.

J Cardiol Cases 2018 Dec 5;18(6):207-209. Epub 2018 Sep 5.

Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

Deep vein thrombosis occasionally causes paradoxical embolism in patients with a patent foramen ovale (PFO). We report the case of a 42-year-old female who was hospitalized for stroke. Detailed investigations revealed the existence of a PFO, pulmonary embolism, and ovarian vein thrombosis extending to inferior vena cava. Read More

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http://dx.doi.org/10.1016/j.jccase.2018.08.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306514PMC
December 2018

Concomitant embolism in the subclavian and pulmonary artery.

Rozhl Chir 2018 ;97(10):478-481

Introduction: Pulmonary embolism is a life-threatening condition that causes obstruction of the pulmonary arteries by an embolus, most often originating from the venous system of the lower limbs or pelvic veins. Depending on the extent of the embolism, an acute right-sided heart failure may result, with subsequent death. Paradoxical embolism is a condition in which a venous thrombus is embolized into the systemic circulation arteries by a right-to-left heart shunt. Read More

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January 2018

Paradoxical Embolism in a Patient with Patent Foramen Ovale; a Case Report.

Emerg (Tehran) 2018 8;6(1):e50. Epub 2018 Aug 8.

Department of Cardiology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Patent foramen ovale (PFO) is usually asymptomatic; however, it could be quite dangerous for patients with right side clot in which thrombus can transmit the PFO and paradoxically emboli to systemic circulation. Here we present a patient with ankle fracture and paradoxical embolus to the brain, who was successfully treated with emergent thrombectomy, inferior vena cava (IVC) filter placement and anticoagulation therapy. Despite the high rate of mortality in these patients, fortunately our patient survived with surgical treatment. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289151PMC
August 2018
1 Read

Paradoxical McConnell's Sign: A Case Report on Right Ventricular Wall Abnormalities in Acute Pulmonary Embolism.

CASE (Phila) 2018 Dec 17;2(6):282-284. Epub 2018 Oct 17.

Department of Cardiology, Drexel University College of Medicine, Philadelphia, Pennsylvania.

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http://dx.doi.org/10.1016/j.case.2018.07.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302120PMC
December 2018

Paradoxical embolism with thrombus stuck in a patent foramen ovale: a review of treatment strategies.

Eur Rev Med Pharmacol Sci 2018 Dec;22(24):8885-8890

Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.

Objective: Paradoxical embolism represents a rare condition occurring when a thrombus originating from venous system produces pulmonary embolism and systemic embolization through an intracardiac or pulmonary shunt. The evidence of a thrombus entrapped in a patent foramen ovale (PFO) is an even more rare condition. There is uncertainty about the optimal treatment strategy. Read More

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http://dx.doi.org/10.26355/eurrev_201812_16657DOI Listing
December 2018

Cryptogenic Stroke: To Close a Patent Foramen Ovale or Not to Close?

J Cent Nerv Syst Dis 2018 16;10:1179573518819476. Epub 2018 Dec 16.

Department of Medicine, The Chicago Medical School, Rosalind Franklin University, North Chicago, IL, USA.

A patent foramen ovale (PFO) has been shown to be highly prevalent in patients diagnosed with strokes of unknown cause, which are also called cryptogenic strokes (CSs). It has been a long-running controversy as to whether a PFO should be closed or not to prevent recurrent strokes in patients diagnosed with CS. A paradoxical embolism that is produced through a PFO is hypothesized to be a leading cause of CS, especially in younger patients with low risk factors for stroke. Read More

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http://dx.doi.org/10.1177/1179573518819476DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297885PMC
December 2018

An unusual case of bilateral pulmonary embolism in a patient on dual venous thromboprophylaxis, secondary to heparin induced thrombocytopenia.

J Community Hosp Intern Med Perspect 2018 11;8(6):376-379. Epub 2018 Dec 11.

Department of Medicine, Pulmonary and Critical Care Division, Interfaith Medical Center, Brooklyn, NY, USA.

Heparin Induced thrombocytopenia (HIT) is a rare, immune-mediated complication of heparin, associated with both thrombocytopenia and paradoxical thrombotic events. Initial diagnosis is made clinically when platelet count falls by 30% to <100 × 10cells/l or a > 50% decrease from baseline count in association with heparin therapy. Thromboembolic complications are seen in 50% of the cases. Read More

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http://dx.doi.org/10.1080/20009666.2018.1554099DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292353PMC
December 2018
1 Read

Early Recurrent Ischemic Lesions in Patients With Cryptogenic Stroke and Patent Foramen Ovale: An Observational Study.

Front Neurol 2018 22;9:996. Epub 2018 Nov 22.

Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.

Randomized controlled trials indicate that patent foramen ovale (PFO) closure reduces risk of stroke recurrence in patients with cryptogenic stroke and PFO. However, the optimal time point for PFO closure is unknown and depends on the risk of stroke recurrence. We aimed to investigate risk of early new ischemic lesions on cerebral magnetic resonance imaging (MRI) in cryptogenic stroke patients with and without PFO. Read More

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http://dx.doi.org/10.3389/fneur.2018.00996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262074PMC
November 2018
1 Read

Paradoxical Thromboembolic Ischemic Stroke and Pulmonary Embolism after Uterine Fibroid Embolization.

J Vasc Interv Radiol 2018 Dec;29(12):1772-1775.e2

Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, AB T2N2T9, Canada; Department of Critical Care Medicine, University of Calgary, Calgary, AB T2N2T9, Canada.

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http://dx.doi.org/10.1016/j.jvir.2018.06.026DOI Listing
December 2018

Clinical and infarction patterns of PFO-related cryptogenic strokes and a prediction model.

Ann Clin Transl Neurol 2018 Nov 24;5(11):1323-1337. Epub 2018 Sep 24.

Department of Neurology Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China.

Objectives: The higher than expected PFO rate in CS patients has raised concerns that paradoxical embolism maybe the pathophysiologic mechanism for strokes. However, only a small proportion of pathogenic PFOs cause CS. Therefore, accurate recognition of patients with pathogenic PFOs among all CS patients could guide clinical decision making in selecting the most appropriate treatment. Read More

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http://doi.wiley.com/10.1002/acn3.647
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http://dx.doi.org/10.1002/acn3.647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243387PMC
November 2018
9 Reads

Iatrogenic Paradoxical Stroke in a Patient With Catheter-Associated Thrombosis and Systemic-to-Pulmonary Venous Shunt.

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618813175. Epub 2018 Nov 15.

SUNY Downstate Medical Center, Brooklyn, NY, USA.

Paradoxical embolism occurs when thrombotic material traverses a right-to-left shunt. We describe the first case of paradoxical stroke resulting from manipulation of a disused chemotherapy port. Contrast studies revealed that the mechanism was systemic-to-pulmonary venous shunt, in which systemic veins drain into the left atrium via collaterals. Read More

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http://dx.doi.org/10.1177/2324709618813175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243407PMC
November 2018
2 Reads

Paradoxical embolism through PFO leading to stroke in a gunshot victim with IVC injury.

J Surg Case Rep 2018 Nov 19;2018(11):rjy308. Epub 2018 Nov 19.

Department of Surgery, UAMS, 4301W Markham St, Little Rock, AR, USA.

A 23-year-old man presented to the emergency department with multiple gunshot wounds to the chest and abdomen, and was taken to the operating room emergently for exploratory laparotomy due to hemodynamic instability. The patient underwent inferior vena cava (IVC), bowel and ureter repair during the procedure, requiring massive amounts of blood products. The patient transferred to the surgical intensive care unit with a routine post-operative course for approximately the next 7 days before presenting with signs of stroke. Read More

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https://academic.oup.com/jscr/article/doi/10.1093/jscr/rjy30
Publisher Site
http://dx.doi.org/10.1093/jscr/rjy308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240738PMC
November 2018
12 Reads

Cardiac Implantable Electronic Device Lead Thrombus as a Nidus for Pulmonary and Systemic Embolization.

JACC Clin Electrophysiol 2018 Nov;4(11):1437-1439

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address:

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http://dx.doi.org/10.1016/j.jacep.2018.08.019DOI Listing
November 2018
1 Read

Predictors of hospital discharge in cancer patients with pericardial effusion undergoing surgical pericardial drainage.

J Surg Oncol 2019 Jan 22;119(1):143-147. Epub 2018 Nov 22.

Division of Thoracic Surgery, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil.

Introduction: Pericardial effusion (PE) is a complication of late-stage cancer and some patients never leave the hospital despite drainage. The main objective of this study was to identify predictors of hospital discharge in cancer patients with (PE) who underwent pericardial drainage. We also report the occurrence of paradoxical hemodynamic instability (PHI). Read More

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http://dx.doi.org/10.1002/jso.25283DOI Listing
January 2019
3 Reads

Advances in Stroke Prevention.

Authors:
J David Spence

J Transl Int Med 2018 Sep 9;6(3):105-114. Epub 2018 Oct 9.

Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Canada.

There have been recent advances in stroke prevention in nutrition, blood pressure control, antiplatelet therapy, anticoagulation, identification of high-risk asymptomatic carotid stenosis, and percutaneous closure of patent foramen ovale. There is evidence that the Mediterranean diet significantly reduces the risk of stroke and that B vitamins lower homocysteine, thus preventing stroke. The benefit of B vitamins to lower homocysteine was masked by harm from cyanocobalamin among study participants with impaired renal function; we should be using methylcobalamin instead of cyanocobalamin. Read More

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http://dx.doi.org/10.2478/jtim-2018-0024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231304PMC
September 2018
2 Reads

Evaluating the cost-effectiveness of percutaneous closure of a patent foramen ovale versus medical management in patients with a cryptogenic stroke: from the UK payer perspective.

J Med Econ 2018 Nov 14:1-9. Epub 2018 Nov 14.

i University of Pennsylvania , Philadelphia , PA , USA.

Aims: Percutaneous closure of a patent foramen ovale (PFO) is known to lower the risk of recurrent stroke in patients with a cryptogenic stroke. However, the economic implications of transcatheter PFO closure are less well known. From a UK payer perspective, a detailed economic appraisal of PFO closure was performed for prevention of recurrent ischemic stroke in patients with a PFO who had experienced a cryptogenic stroke. Read More

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https://www.tandfonline.com/doi/full/10.1080/13696998.2018.1
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http://dx.doi.org/10.1080/13696998.2018.1548355DOI Listing
November 2018
16 Reads

Teaching NeuroImages: Complex bilateral corpus callosum infarction after paradoxical embolism: Lightning strikes twice.

Neurology 2018 Nov;91(20):e1947-e1948

From the Departments of Neurology (G.V.C.d.O.C., M.H.L.P., S.C.O.M., R.B., A.G.d.A.), Internal Medicine (S.C.O.M.), and Radiology (J.A.D.), Hospital de Clínicas de Porto Alegre, Brazil.

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http://dx.doi.org/10.1212/WNL.0000000000006505DOI Listing
November 2018

An Autopsy Case of Paradoxical Pulmonary Thromboembolism by Arteriovenous Fistula from Right Common Iliac Artery to Common Iliac Vein: A Rare Cause of Pulmonary Embolism.

Am J Case Rep 2018 Nov 1;19:1301-1305. Epub 2018 Nov 1.

Division of Respiratory Disease, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.

BACKGROUND Pulmonary thromboembolism (PTE) sometimes leads to a shock state and sudden death due to acute massive pulmonary arterial thrombosis. The origins of pulmonary arterial thrombi are varied, but most arise from deep vein thrombosis. We herein presented a very rare cause of PTE due to paradoxical embolism caused by arteriovenous fistula from common iliac artery to common iliac vein. Read More

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https://www.amjcaserep.com/abstract/index/idArt/910982
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http://dx.doi.org/10.12659/AJCR.910982DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223196PMC
November 2018
4 Reads

Paradoxical brain embolism due to a popliteal venous aneurysm after minor orthopedic surgery in a 19-year-old man with patent foramen ovale: A case report.

J Orthop Sci 2018 Oct 20. Epub 2018 Oct 20.

Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan.

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http://dx.doi.org/10.1016/j.jos.2018.09.019DOI Listing
October 2018
7 Reads

Thrombus straddling a patent foramen ovale, pulmonary embolism and paradoxical embolism: a rare trifecta.

BMJ Case Rep 2018 Oct 17;2018. Epub 2018 Oct 17.

Cardiology, St Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA.

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http://dx.doi.org/10.1136/bcr-2018-227505DOI Listing
October 2018
8 Reads

Role of Echocardiography in Assessment of Cardioembolic Sources: a Strong Diagnostic Resource in Patients with Ischemic Stroke.

Curr Cardiol Rep 2018 Oct 11;20(12):136. Epub 2018 Oct 11.

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, 2801 W. Kinnickinnic River Parkway, Ste. 880, Milwaukee, WI, 53215, USA.

Purpose Of Review: This review will discuss the most frequent sources of cardiac embolism and the role of echocardiography in these different clinical settings, and, in addition, provide suggestions about the choice between transthoracic (TTE) and transesophageal echocardiography (TEE).

Recent Findings: Stroke is the third leading cause of death in industrial countries, and 15-40% of all ischemic strokes are due to cardioembolism. TTE and TEE are cornerstones in the detection of cardioembolic sources and provide fundamental information about the embolic risk and most suitable treatment of these patients, improving long-term outcomes. Read More

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http://link.springer.com/10.1007/s11886-018-1085-5
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http://dx.doi.org/10.1007/s11886-018-1085-5DOI Listing
October 2018
9 Reads

RoPE Score as a Predictor of Recurrent Ischemic Events After Percutaneous Patent Foramen Ovale Closure.

Int Heart J 2018 Nov 10;59(6):1327-1332. Epub 2018 Oct 10.

Cardiology University Centre, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central.

The benefits of patent foramen ovale (PFO) closure for cryptogenic stroke secondary prevention are still debated. The Risk of Paradoxical Embolism (RoPE) study developed a score to improve patient selection for this procedure. We proposed to assess the validity of this score to assess the prognostic impact of PFO closure. Read More

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https://www.jstage.jst.go.jp/article/ihj/advpub/0/advpub_17-
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http://dx.doi.org/10.1536/ihj.17-489DOI Listing
November 2018
26 Reads

Identification of candidates for PFO closure in the echocardiography laboratory.

Echocardiography 2018 11 10;35(11):1860-1867. Epub 2018 Oct 10.

Division of Cardiovascular Diseases, Department of Medicine, University of Mississippi School of Medicine, Jackson, Mississippi.

A patent foramen ovale (PFO) is implicated in several pathologic processes, including that of cryptogenic stroke (cCVA). Recent trials identify "high-risk" PFOs in patients with cCVA as likely to benefit from percutaneous closure. The younger the patient (<60 years old) the more likely a PFO may be attributable to the cCVA. Read More

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http://doi.wiley.com/10.1111/echo.14154
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http://dx.doi.org/10.1111/echo.14154DOI Listing
November 2018
8 Reads

A Rare Cause of Stroke FourWeeks After Ascending Aortic Aneurysm Repair.

J Cardiothorac Vasc Anesth 2018 Sep 8. Epub 2018 Sep 8.

Anesthesia Service, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S10530770183087
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http://dx.doi.org/10.1053/j.jvca.2018.09.002DOI Listing
September 2018
6 Reads

Embolizing Massive Right Atrial Thrombus in a HIV-Infected Patient.

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618802871. Epub 2018 Sep 28.

Kern Medical Center, Bakersfield, CA, USA.

The risk of thromboembolism is increased when associated with the human immunodeficiency viral (HIV) infection. Various factors are involved in promoting thrombosis, and the presence of a patent foramen ovale augments the potential for a paradoxical embolism. We describe the case of a 56-year-old man receiving antiretroviral therapy with features of right heart failure and pulmonary embolism. Read More

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http://journals.sagepub.com/doi/10.1177/2324709618802871
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http://dx.doi.org/10.1177/2324709618802871DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166303PMC
September 2018
15 Reads

Cryptogenic stroke secondary to paradoxical embolism: Is this event rare or underdiagnosed?

Emergencias 2018 Oct;30(5):367-368

Servicio de Urgencias, Hospital Universitario Clínico San Carlos, Madrid, España.

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October 2018
1 Read

[Neuroimaging characteristics of cryptogenic stroke with and without patent foramen ovale].

Zhonghua Yi Xue Za Zhi 2018 Sep;98(33):2636-2640

Department of Neurology, Henan Provincial People's Hospital, Zhengzhou 450003, China.

To explore the neuroimaging characteristics associated with the presence of patent foramen ovale(PFO) for patients with cryptogenic stroke. We retrospectively collected the clinical and imaging data of cryptogenic stroke patients with PFO and without PFO from Henan Province People's Hospital from January 1, 2013 to June 30, 2017. Lesion patterns and pertinent vascular territory were compared between the two groups. Read More

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http://doi.med.wanfangdata.com.cn/10.3760/cma.j.issn.0376-24
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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2018.33.005DOI Listing
September 2018
8 Reads

[InterAtrial Shunt Device in diastolic heart failure].

Internist (Berl) 2018 Oct;59(10):1054-1062

Herzzentrum, Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

All types of heart failure are associated with reduced cardiac output and/or increased left atrial (LA) pressure. In diastolic heart failure (heart failure with preserved ejection fraction [HFpEF]), the increased LA pressure plays a central role, leading to pulmonary venous hypertension (PVH) and increased pulmonary artery pressure. These pressure parameters are presumably decisive for the symptoms and mortally of heart failure, particularly of the diastolic form. Read More

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http://dx.doi.org/10.1007/s00108-018-0484-4DOI Listing
October 2018
1 Read

Massive air embolism while removing a central venous catheter.

Int J Crit Illn Inj Sci 2018 Jul-Sep;8(3):176-178

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Jeju National University Hospital, Jeju National University, Jeju, Korea.

Air embolism is a rare but mostly iatrogenic complication of medical or surgical procedures and may have a serious outcome. On the removal of a central venous catheter (CVC), minor carelessness can lead to a venous air embolism sometimes accompanied by arterial embolism. We experienced the case of a 61-year-old male who suffered from a paradoxical systemic air embolism while we removed a CVC. Read More

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http://dx.doi.org/10.4103/IJCIIS.IJCIIS_14_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116308PMC
September 2018
16 Reads

Patent foramen ovale and atrial fibrillation as causes of cryptogenic stroke: is treatment with surgery superior to device closure and anticoagulation? A review of the literature.

Acta Radiol Open 2018 Sep 23;7(9):2058460118793922. Epub 2018 Aug 23.

1Department of Cardiothoracic Surgery, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

Closure of persistent foramen ovale (PFO) to avoid cryptogenic strokes is performed globally with enthusiasm but lacks prove of efficacy. We present a 79-year-old man who had had a PFO device introduced nine years previously because of cryptogenic strokes presenting as syncopes. The patient was referred from his general practitioner with two new syncopes. Read More

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http://journals.sagepub.com/doi/10.1177/2058460118793922
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http://dx.doi.org/10.1177/2058460118793922DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6109859PMC
September 2018
14 Reads

Entrapped paradoxical thromboembolism.

Authors:
Roger W Byard

Forensic Sci Med Pathol 2018 Aug 28. Epub 2018 Aug 28.

Faculty of Medicine, The University of Adelaide, Level 2 Helen Mayo Building North, Frome Road, Adelaide, 5005, Australia.

A 67-year-old obese woman (BMI 38.3) was found at autopsy to have deep venous thrombosis of the left calf with bilateral peripheral and saddle pulmonary thromboemboli and a 165 mm long segment of paradoxical thromboembolus wedged between the right and left atria through a patent foramen ovale. Death was due to acute right-sided decompensation caused by obstruction of the pulmonary outflow tract from bilateral pulmonary thromboemboli. Read More

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http://dx.doi.org/10.1007/s12024-018-0023-6DOI Listing
August 2018
10 Reads

Ischaemic Stroke and the Echocardiographic "Bubble Study": Are We Screening the Right Patients?

Heart Lung Circ 2018 Aug 6. Epub 2018 Aug 6.

Department of Cardiology, Sir Charles Gairdner Hospital, Perth, WA, Australia; University of Western Australia School of Medicine, WA, Australia.

Background: Patent foramen ovale (PFO) is a potential mechanism for paradoxical embolism in cryptogenic ischaemic stroke or transient ischaemic attack (TIA). PFO is typically demonstrated with agitated saline ("bubble study", BS) during echocardiography. We hypothesised that the BS is frequently requested in patients that have a readily identifiable cause of stroke, that any PFO detected is likely incidental, and its detection often does not alter management. Read More

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http://dx.doi.org/10.1016/j.hlc.2018.07.007DOI Listing
August 2018
2 Reads

Pulmonary embolism developing after therapeutic drainage of malignant pleural effusions.

Respir Med Case Rep 2018 7;25:122-123. Epub 2018 Aug 7.

Department of Medicine, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region.

We reported three cases of pulmonary embolism which presented acutely and was confirmed shortly after therapeutic drainage of malignant pleural effusion. The temporal association may suggest that massive pleural effusion can be a risk factor for pulmonary embolism arising from venous thrombosis of lower limbs in patients with malignancies. This association can be related to the intra-thoracic pressure changes related to therapeutic pleural drainage. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22130071183000
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http://dx.doi.org/10.1016/j.rmcr.2018.08.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098215PMC
August 2018
8 Reads

Percutaneous closure of patent foramen ovale for paradoxical embolism in acute limb ischemia.

Cardiovasc Interv Ther 2018 Aug 14. Epub 2018 Aug 14.

Department of Cardiology, Tokushima Red Cross Hospital, 103 Irinokuchi, Komatsushima-cho, Komatsushima, Tokushima, 773-8502, Japan.

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http://dx.doi.org/10.1007/s12928-018-0542-9DOI Listing
August 2018
2 Reads

ST-segment elevation myocardial infarction possibly caused by thromboembolism from left atrial appendage thrombus after incomplete surgical ligation.

Echocardiography 2018 11 13;35(11):1889-1892. Epub 2018 Aug 13.

Department of Cardiology, Kosuyolu Kartal Training and Research Hospital, Istanbul, Turkey.

Coronary embolism (CE) is the underlying cause of 3% of acute coronary syndromes but is frequently overlooked in the differential diagnoses of acute coronary syndromes. The CE may be direct (left sided from the native or prosthetic heart valve, the left atrium, left atrial appendage or pulmonary venous bed), paradoxical (from the venous circulation through a patent foramen ovale, atrial septal defect, ventricular septal defects, cyanotic congenital heart defects or pulmonary arteriovenous malformations), or iatrogenic (following cardiac interventions. In patients with atrial fibrillation (AF), left atrial appendage (LAA) ligation during mitral valve surgery has long been recommended to decrease the future risk of embolic events such as myocardial infarction or ischemic stroke. Read More

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http://dx.doi.org/10.1111/echo.14123DOI Listing
November 2018
2 Reads

Frequent Arterial Emboli in a Patient with Acute Pulmonary Thromboembolism and Patent Foramen Ovale.

Ann Vasc Surg 2018 Nov 4;53:274.e7-274.e10. Epub 2018 Aug 4.

Assistant Professor of Internal Medicine, Department of Internal Medicine, Rasoul-e-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran.

Although patent foramen ovale (PFO) is a relatively common condition, the risk of paradoxical embolism is less than 2% of all arterial ischemia. We present the case of a 52-year-old man diagnosed with pulmonary thromboembolism complicated with 2 events of paradoxical emboli in the left upper and right lower limbs secondary to PFO. We also discuss some uncertainties behind the management of PFO patients after an episode of venous thromboembolism. Read More

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http://dx.doi.org/10.1016/j.avsg.2018.05.048DOI Listing
November 2018
2 Reads

Percutaneous closure of residual shunting in a patient with a fenestrated atrial septal defect occluder: A case report.

Medicine (Baltimore) 2018 Aug;97(31):e11612

Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Heart Center, Shanghai, China.

Rationale: Fenestrated atrial septal defect (ASD) occlusion has been performed in patients complicated with severe pulmonary hypertension (PH). Nevertheless, the persistent interatrial residual shunting in the fenestration might increase the risk of paradoxical embolism. Percutaneous closure of fenestrated ASD occluder (ASO) has not yet been reported. Read More

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http://dx.doi.org/10.1097/MD.0000000000011612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081157PMC
August 2018
4 Reads
5.720 Impact Factor

May-Thurner Syndrome as a Rare Cause of Paradoxical Embolism in a Patient with Patent Foramen Ovale.

Case Rep Cardiol 2018 2;2018:3625401. Epub 2018 Jul 2.

Department of Cardiology, Michigan State University and Borgess Medical Center, 1521 Gull Rd, Kalamazoo, MI 49048, USA.

May-Thurner syndrome is an underrecognized anatomical variant that can lead to increased propensity for venous thrombosis in the lower extremities. We present a case of a 67-year-old female who presented with transient ischemic attack. Initial workup including CT scan of the head, MRI scan of the head, and magnetic resonance angiogram of the head and neck was unremarkable. Read More

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http://dx.doi.org/10.1155/2018/3625401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051101PMC
July 2018
2 Reads

Patent foramen ovale and cryptogenic stroke: diagnosis and updates in secondary stroke prevention.

Stroke Vasc Neurol 2018 Jun 26;3(2):84-91. Epub 2018 Jun 26.

Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

The patent foramen ovale (PFO), given its high prevalence in the general population and especially in patients with cryptogenic stroke, has long generated investigation and debate on its propensity for stroke by paradoxical embolism and its management for stroke prevention. The pendulum has swung for percutaneous PFO closure for secondary stroke prevention in cryptogenic stroke. Based on a review of current evidence, the benefit from PFO closure relies on careful patient selection: those under the age of 60 years with few to no vascular risk factors and embolic-appearing stroke deemed cryptogenic after thorough evaluation. Read More

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http://dx.doi.org/10.1136/svn-2018-000173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047340PMC
June 2018
5 Reads

Cardioembolic stroke: everything has changed.

Authors:
J David Spence

Stroke Vasc Neurol 2018 Jun 9;3(2):76-83. Epub 2018 Mar 9.

Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada.

Historically, because of the difficulty of using warfarin safely and effectively, many patients with cardioembolic stroke who should have been anticoagulated were instead given ineffective antiplatelet therapy (or no antithrombotic therapy). With the arrival of new oral anticoagulants that are not significantly more likely than aspirin to cause severe haemorrhage, everything has changed. Because antiplatelet agents are much less effective in preventing cardioembolic stroke, it is now more prudent to anticoagulate patients in whom cardioembolic stroke is strongly suspected. Read More

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http://dx.doi.org/10.1136/svn-2018-000143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047338PMC
June 2018
1 Read

Paradoxical Embolism in a Patient with Aortic Valve Endocarditis: A Case Report.

Cureus 2018 Mar 10;10(3):e2301. Epub 2018 Mar 10.

Division of Cardiology, Duke University Medical Center.

This report describes a case of aortic valve endocarditis with systemic and paradoxical pulmonary embolism in a patient with congenital interventricular communication. The patient underwent cardiac surgery and did not have a favorable outcome, presenting refractory cardiogenic shock and subsequently dying while in the hospital. This is an extremely rare case of paradoxical embolism in a patient with infective endocarditis; only four similar cases have been reported in the literature. Read More

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http://dx.doi.org/10.7759/cureus.2301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039223PMC
March 2018
2 Reads

Computational Flow Dynamic Analysis of Right and Left Atria in Patent Foramen Ovale: Potential Links with Atrial Fibrillation.

J Atr Fibrillation 2018 Feb 28;10(5):1852. Epub 2018 Feb 28.

Department of Cardiology, Clinical Research Center, Sarawak General Hospital, Sarawak, Malaysia.

Background: An impairment of the left atrial function similar to that usually observed in atrial fibrillation (AF) has been observed also in patients with patent foramen ovale (PFO) and permanent right-to-left shunting (RLS).

Methods: We reconstructed the geometrical model of right atrium (RA), PFO, left atrium (LA) and left atrial appendage (LAA) of 65 patients with mild (36 patients mean age 45.5±6. Read More

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http://dx.doi.org/10.4022/jafib.1852DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006970PMC
February 2018
2 Reads

Treatment of Platypnea-Orthodeoxia Syndrome in a Patient with Normal Cardiac Hemodynamics: A Review of Mechanisms with Implications for Management.

Methodist Debakey Cardiovasc J 2018 Apr-Jun;14(2):141-146

CORE PHYSICIANS, EXETER, NEW HAMPSHIRE.

Platypnea-orthodeoxia syndrome is a rare entity characterized by dyspnea and hypoxemia in the sitting position and usually resolved by lying down. Although it is not well understood, it is thought to be associated with either intracardiac or extracardiac factors. Within the group of intracardiac etiologies, it typically occurs in the presence of right heart failure or elevated right-sided filling pressures. Read More

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http://dx.doi.org/10.14797/mdcj-14-2-141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027726PMC
October 2018
2 Reads

Echocardiographic features of PFOs and paradoxical embolism: a complicated puzzle.

Int J Cardiovasc Imaging 2018 Dec 28;34(12):1849-1861. Epub 2018 Jun 28.

1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, 114 Vas. Sofias, 11527, Athens, Greece.

Patent foramen ovale (PFO) is a residual, oblique, slit or tunnel like communication in the atrial septum that persists into adulthood. It is usually an incidental finding with no clinical repercussions. Nevertheless, recent evidence supports the association between the presence of a PFO and a number of clinical conditions, most notably cryptogenic stroke (CS). Read More

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http://dx.doi.org/10.1007/s10554-018-1406-1DOI Listing
December 2018
2 Reads

Role of closure of patent foramen ovale in cryptogenic stroke: Current status.

Natl Med J India 2017 Sep-Oct;30(5):268-271

Department of Cardiology, Vydehi Institute of Medical Sciences and Research Centre, # 82, EPIP Area, Whitefield, Bengaluru 560066, Karnataka, India.

Ischaemic stroke is among the leading causes of disability and death. Despite extensive vascular, cardiac and serological evaluations, the cause remains unknown in 20%-40% of patients. These are classified as cryptogenic stroke. Read More

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http://dx.doi.org/10.4103/0970-258X.234394DOI Listing
December 2018
2 Reads

Migraine and cerebrovascular disease: still a dangerous connection?

Neurol Sci 2018 Jun;39(Suppl 1):33-37

Neurology and Stroke Unit, Department of Neurosciences, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy.

Migraine is a common type of headache in young adults, with an estimated prevalence of 4% before puberty and as high as 25% in women by their mid to late 30s. About one third of migraineurs experience transient neurological symptoms known as auras, which characterize a variant known as migraine with aura. Many evidences have shown an increased risk of vascular events in patients affected by migraine, particularly among women and among migraine patients with aura. Read More

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http://dx.doi.org/10.1007/s10072-018-3429-8DOI Listing
June 2018
1 Read