Key result
Upper extremity DVT triggers concurrent submassive PE and paradoxical STEMI via PFO in young female.
Why the study?
Paradoxical thromboembolism via a patent foramen ovale in sub-massive pulmonary embolism following upper extremity deep venous thrombosis is a rare clinical phenomenon requiring detailed discussion.
Case Report (n=1)
This case highlights the rare occurrence of paradoxical thromboembolism captured in-transit via a PFO, leading to STEMI and upper extremity embolism following an upper extremity DVT.
May prompt TTE in young patients with concurrent PE and STEMI; leaves open optimal management pending prospective data.
The objective of this case study is to discuss a rare case of proven paradoxical thromboembolism captured in-transit. A 23-year-old female with a diagnosis of right internal jugular deep vein thrombus who developed acute onset chest pain, dyspnea and hypotension, was selected for the study. Sub-massive PE and STEMI were diagnosed. Transthoracic echocardiogram revealed a left ventricular (LV) mass moving across the aortic valve. Soon after, the patient developed numbness of right extremities with non-palpable pulses. A transesophageal echocardiogram revealed absent LV mass, PFO, left atrial mass entering through the PFO and emboli in bilateral pulmonary arteries. We report a case of sub-massive PE and paradoxical proven coronary and upper extremity embolism, captured in-transit, following destabilization of an UEDVT in a patient with PFO.
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Deepali Nivas Tukaye (2014) conducted a case report in Paradoxical thromboembolism, STEMI, Sub-massive PE, UEDVT (n=1). Paradoxical thromboembolism via PFO was evaluated on Clinical outcome. A 23-year-old female with an upper extremity deep venous thrombosis developed a sub-massive pulmonary embolism and a paradoxical ST-elevation myocardial infarction via a patent foramen ovale.
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