IMPENDING PARADOXICAL EMBOLISM

The advent of echocardiography has led to the more frequent discovery of impending paradoxical embolism. Paradoxical embolism should be cons idered whenever there is an arterial embolism from an unidentified sou rce in the presence of a concomitant venous thromboembolic phenomenon. Patients with paradoxical embolism present with neurological abnormal ities or features suggesting arterial embolism. Annually, paradoxical embolism may account for up to 47 000 strokes in the United States, an d a patent foramen ovale has been reported in up to 35% of the normal population, Events that give rise to pulmonary hypertension may result in a right-to-left shunt through a patent foramen ovale allowing a ve nous thromboembolism access to the arterial circulation. Herein we rep ort a case of impending paradoxical embolism and review the pertinent literature.