Paradoxical embolism via patent foramen ovale induced by deep venous thrombosis and acute pulmonary embolism.

A 32-year-old man presented with acute pulmonary embolism, deep vein thrombosis, and lower extremity arterial ischemia after prolonged driving. He underwent emergency thrombolysis, thrombectomy, and inferior vena cava filter placement, and potential intra-atrium shunt was detected during the angiography. Postoperative recovery showed improved oxygenation and limb perfusion. Follow-up confirmed a right-to-left shunt via a patent foramen ovale, causing paradoxical embolism. In this article, we report and analyze this specific case. Additionally, we conduct a comprehensive review of the literature pertaining to patent foramen ovale and paradoxical embolism. Based on these insights, we propose the treatment principles for paradoxical embolism.