Symptoms of pulmonary thromboembolism and associated peripheral arterial embolism suggest a diagnosis of paradoxical embolism. This condition requires the presence of a venous thrombus and a right-to-left shunt as patent foramen ovale (PFO).
PFO is present in as many as 35% of the normal population: however, in literature, there have been few case reports of paradoxical embolism in peripheral arteries coincident with acute pulmonary thromboembolism and deep venous thrombosis.
This case report describes a patient with paradoxical peripheral embolism associated with PFO (large shunt) who was diagnosed by transcranial Doppler with contrast agent: mixture of saline solution (9ml) and air (1 ml).
Franco Accorsi, MD
Member of the Order of Physician of Bologna n° 6728
I am a specialist in Medical Angiology and I am based in Bologna, Italy. Until 2008 (voluntary resignation) I worked at Maggiore Hospital in Bologna as "Dirigente Medico" in the Department of Internal Medicine and as Angiologist in the Angiology Unit with a position of "Alta Professionalità" in "Vascular Ecography and Angiology".
I am currently working in Bologna as an independent professional in the areas of angiology and vascular diagnostics.
I have been a speaker at national and international courses/congress and I have taught duplex ultrasound method in GIUV and SIUMB courses at the Maggiore Hospital, Bologna and courses of echocolor Doppler of extracranial and intracranial arteries at the Stroke Unit of S. Maria Nuova Hospital, Reggio Emilia.