Paradoxical Embolism

A paradoxical embolus is one that arises in the systemic veins or right side of the heart and crosses into the systemic arterial circulation through such a communication as a septal defect.The diagnosis may be established by finding the embolus caught in transit through the opening, or in other cases a presumptive diagnosis may be made: here it is necessary to demonstrate a source of emboli in the systemic venous system, an abnormal communication between the venous and arterial circulations, systemic arterial emboli, and the absence of an embolic source in the pul- monary veins, left heart, or systemic arteries.Johnson reviewed the published material in 1951 and collected 40 verified and 46 presumptive cases.Two more verified cases are reported here and the recent reported cases are reviewed.