Multidisciplinary Management for Concomitant High-Risk Pulmonary Embolism and Large-Vessel Occlusion Stroke From Paradoxical Embolism
Concurrent pulmonary embolism (PE) and acute ischemic stroke are uncommon but associated with high morbidity. Paradoxical embolism occurs when thrombi cross right-to-left cardiac/pulmonary shunts such as a patent foramen ovale. Early anticoagulation for PE may lead to hemorrhagic transformation in l...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American College of Physicians
2025-05-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0597 |
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| Summary: | Concurrent pulmonary embolism (PE) and acute ischemic stroke are uncommon but associated with high morbidity. Paradoxical embolism occurs when thrombi cross right-to-left cardiac/pulmonary shunts such as a patent foramen ovale. Early anticoagulation for PE may lead to hemorrhagic transformation in large acute ischemic strokes. Decisions for reperfusion therapies and anticoagulation are time-sensitive, with best outcomes achieved with a multidisciplinary approach. We present a patient with concurrent high-risk PE and right middle cerebral artery stroke from paradoxical embolism through a patent foramen ovale who received neurothrombectomy followed by pulmonary aspiration thrombectomy. |
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| ISSN: | 2767-7664 |