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Case Report

Online Publishing Date:
28 / 01 / 2022

 


Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale

Jose Pereira, Juliana Magalhes, Djalma Sousa, Carla Henriques, Sergio Borges, Ana Costa, Ines Antunes.


Abstract
Introduction: The prevalence of patent foramen ovale (PFO) is around 25% of the general population and constitutes about 95% of all right-to-left intracardiac shunts. In most cases never causes a health disturbance, but sometimes is associated with paradoxical embolism. It usually occurs in combination with pulmonary thromboembolism, which suddenly increases the right heart pressure, favouring thrombus displacement. The risk of paradoxical embolization (PE) may be increased by the presence of the two most common genetic risk factors for venous thrombosis: factor V Leiden (G1691A) and prothrombin (PT) G20210A.
The detection of thrombus passage throw PFO allows the definitive diagnosis of paradoxical embolism, but as it is a transient phenomenon, it was rarely described in the literature.
Case Report: A 29-year-old Syrian woman was admitted to the emergency department, referring to chest pain, dyspnea and palpitations, of sudden onset. With a previous illness history of stroke at age 18 and obesity. She was followed up in a Neurology consultation, where a prothrombin gene mutation (G20210-A) was diagnosed and medicated with acetylsalicylic acid. Chest CT angiography was performed, which documented bilateral pulmonary thromboembolism and it was identified a large thrombus crossing the foramen ovale in a transthoracic echocardiogram. Anticoagulation with unfractionated heparin was started and she was later transferred to the cardiothoracic surgery department.
Conclusion: In this case, we highlight the coexistence of genetic and structural risk factors, which culminate in a rare case of pulmonary thromboembolism with atypical presentation of large thrombus crossing the foramen ovale, with potential for pulmonary and systemic embolization.

Key words: patent foramen ovale, paradoxical embolism, prothrombin G20210A, pulmonary thromboembolism, thrombus


 
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How to Cite this Article
Pubmed Style

Pereira J, Magalhes J, Sousa D, Henriques C, Borges S, Costa A, Antunes I. Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. Int J Med Rev Case Rep. 2022; 6(2): 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale

Web Style

Pereira J, Magalhes J, Sousa D, Henriques C, Borges S, Costa A, Antunes I. Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. https://www.mdpub.net/?mno=71040 [Access: April 04, 2024]. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale

AMA (American Medical Association) Style

Pereira J, Magalhes J, Sousa D, Henriques C, Borges S, Costa A, Antunes I. Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. Int J Med Rev Case Rep. 2022; 6(2): 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


Vancouver/ICMJE Style

Pereira J, Magalhes J, Sousa D, Henriques C, Borges S, Costa A, Antunes I. Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. Int J Med Rev Case Rep. (2022), [cited April 04, 2024]; 6(2): 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


Harvard Style

Pereira, J., Magalhes, . J., Sousa, . D., Henriques, . C., Borges, . S., Costa, . A. & Antunes, . I. (2022) Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. Int J Med Rev Case Rep, 6 (2), 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


Turabian Style

Pereira, Jose, Juliana Magalhes, Djalma Sousa, Carla Henriques, Sergio Borges, Ana Costa, and Ines Antunes. 2022. Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. International Journal of Medical Reviews and Case Reports, 6 (2), 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


Chicago Style

Pereira, Jose, Juliana Magalhes, Djalma Sousa, Carla Henriques, Sergio Borges, Ana Costa, and Ines Antunes. "Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale." International Journal of Medical Reviews and Case Reports 6 (2022), 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


MLA (The Modern Language Association) Style

Pereira, Jose, Juliana Magalhes, Djalma Sousa, Carla Henriques, Sergio Borges, Ana Costa, and Ines Antunes. "Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale." International Journal of Medical Reviews and Case Reports 6.2 (2022), 20-23. Print. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


APA (American Psychological Association) Style

Pereira, J., Magalhes, . J., Sousa, . D., Henriques, . C., Borges, . S., Costa, . A. & Antunes, . I. (2022) Acute pulmonary embolism in a young female with inherited thrombophilic disorder and large thrombus through a patent foramen ovale. International Journal of Medical Reviews and Case Reports, 6 (2), 20-23. doi:10.5455/IJMRCR.Acutepulmonaryembolisminayoungfemale


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