Abstract
Paradoxical embolism (PDE) is an uncommon but clinically important entity. In clinical practice, PDE involving multiple organs is a rarely reported occurrence. Herein, we present a case of acute pulmonary embolism complicated by PDE through an atrial septal defect (ASD) causing a series of embolic events. Subsequent laboratory screening confirmed the patient to be a heterozygous carrier of the factor V Leiden mutation that increases the risk for deep venous thrombosis (DVT). The patient was treated with warfarin indefinitely and underwent transcatheter ASD closure and implantation of an inferior vena cava filter.
Zusammenfassung
Eine paradoxe Embolie (PDE) stellt eine ungewöhnliche, aber klinisch bedeutende Erkrankung dar. Im klinischen Alltag wird über eine PDE mit Beteiligung mehrerer Organe nur sehr selten berichtet. Hier wird der Fall einer akuten Lungenembolie vorgestellt, bei dem die Komplikation einer PDE durch einen Vorhofseptumdefekt (ASD) auftrat und eine Reihe embolischer Ereignisse verursachte. Die anschließende Laborscreeninguntersuchung ergab, dass der Patient ein heterozygoter Träger der Faktor-V-Leiden-Mutation war, welche das Risiko einer tiefen Beinvenenthrombose (DVT) erhöht. Bei dem Patienten erfolgte eine Therapie mit Warfarin auf unbegrenzte Zeit und ein Transkatheter-ASD-Verschluss sowie die Implantation eines V.-cava-inferior-Filters.
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Conflict of interest. L. Tang, Z.F. Fang, and S.H. Zhou state that there are no conflicts of interest. Consent was obtained from all patients identifiable from images or other information within the manuscript. In the case of underage patients, consent was obtained from a parent or legal guardian.
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Tang, L., Fang, Z. & Zhou, S. Paradoxical embolism causing acute embolic events in a patient with hereditary thrombophilia. Herz 40, 314–317 (2015). https://doi.org/10.1007/s00059-013-3994-9
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DOI: https://doi.org/10.1007/s00059-013-3994-9