Simultaneous Systemic/Pulmonary Embolism Caused by Deep Vein Thrombosis

Abstract

Paradoxical embolism may occur in patients with acute pulmonary thromboembolism when patent foramen ovale (PFO) coexists with pulmonary hypertension (right-to-left shunt). There have been few case reports of paradoxical embolism in arteries coincident with acute pulmonary thromboembolism. We report two cases with acute pulmonary thromboembolism associated with paradoxical embolism. Transesophageal echocardiography revealed a giant thrombus trapped in the foramen ovale, and right-to-left shunt was detected by contrast echocardiography.