JACC. Case reports · 2026
Pulmonary Embolism, Silent Stroke, and an Occult Caval Thrombus: 1 Clot, 3 Territories.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Le Truong Q, Giang Nhat M, Nguyen Hai H, Bui Thanh M
Аннотация
BACKGROUND: Clot in transit (CIT) through a patent foramen ovale (PFO) with concomitant pulmonary embolism is a rare condition that carries high mortality and lacks established management guidelines.
CASE SUMMARY: A 67-year-old woman presented with 5 days of exertional dyspnea. Echocardiography showed a mobile thrombus traversing the atrial septum through a PFO with right ventricular dysfunction. Computed tomography pulmonary angiography demonstrated a saddle embolus, and brain imaging revealed a clinically silent paradoxical infarct. Compression ultrasonography showed no deep vein thrombosis. During emergency embolectomy with PFO closure, an unsuspected inferior vena cava thrombus was retrieved.
DISCUSSION: CIT requires direct assessment of the pulmonary, systemic arterial, and venous axes before reperfusion is selected; computed tomography pulmonary angiography does not reliably assess the inferior vena cava.
TAKE-HOME MESSAGE: When CIT is identified, interrogate the caval axis directly rather than inferring it from a negative pulmonary angiogram.
CASE SUMMARY: A 67-year-old woman presented with 5 days of exertional dyspnea. Echocardiography showed a mobile thrombus traversing the atrial septum through a PFO with right ventricular dysfunction. Computed tomography pulmonary angiography demonstrated a saddle embolus, and brain imaging revealed a clinically silent paradoxical infarct. Compression ultrasonography showed no deep vein thrombosis. During emergency embolectomy with PFO closure, an unsuspected inferior vena cava thrombus was retrieved.
DISCUSSION: CIT requires direct assessment of the pulmonary, systemic arterial, and venous axes before reperfusion is selected; computed tomography pulmonary angiography does not reliably assess the inferior vena cava.
TAKE-HOME MESSAGE: When CIT is identified, interrogate the caval axis directly rather than inferring it from a negative pulmonary angiogram.