Paradoxical Embolism

Excerpt

Paradoxical embolism is an uncommon cause for acute arterial occlusion. Paradoxical Embolism (PDE) occurs when a thrombus crosses an intracardiac defect into the systemic circulation. Patients may present with symptoms based on the site of the resultant embolization. These sites can include the brain, heart, gastrointestinal tract, or extremities. Patients may present with a cerebrovascular event, chest pain, migraine, cold extremity, or mesenteric ischemia. The emboli is usually a blood clot but maybe a fat particle, air, amniotic fluid, or tumor. The management of paradoxical embolism is medical and/or surgery, depending on the location of the embolus. Many physicians treat their patients based on a presumptive diagnosis of PDEgiven the challenge of obtaining a definitive diagnosis.