# A case of impending paradoxical embolism

## TL;DR

A rare case of impending paradoxical embolism was successfully treated by removing a heart thrombus before it caused serious complications.

## Contribution

This paper presents a successful treatment approach for impending paradoxical embolism using direct thrombus removal.

## Key findings

- A thrombus lodged in a patent foramen ovale was diagnosed in a 24-year-old woman with chest pain and dyspnea.
- The thrombus was successfully removed under cardiopulmonary bypass, preventing arterial embolism.
- The patent foramen ovale was closed during the procedure to prevent future occurrences.

## Abstract

Impending paradoxical embolism (IPDE) is a rare condition characterized by the presence of a thrombus in a patent foramen ovale. We were able to image a thrombus lodged in a patent foramen ovale and remove the thrombus before it could result in arterial embolism.

A 24-year-old woman was admitted to our hospital with chest pain and dyspnea. Pulmonary embolism was diagnosed via computed tomography. Additionally, transesophageal echocardiography revealed a thrombus lodged in a patent foramen ovale and fluttering in both atria, leading to a diagnosis of IPDE. Rather than incurring the risk associated with embolization by thrombolytic treatment, we elected to remove the incarcerated thrombus and close the patent foramen ovale under cardiopulmonary bypass.

We successfully treated a case of IPDE by removing the thrombus under cardiopulmonary bypass, before arterial thrombosis could occur.