Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jun 29;93(S1):e2022209.
doi: 10.23750/abm.v93iS1.12948.

Pulmonary embolism and renal artery thrombosis in a patient with patent foramen ovale

Carlo Bova  1 , Rossana Calcaterra  2 , Andrea De Vuono  3 , Francesca Serena Pignataro  4 , Elio Fiaschi  5
Affiliations
Case Reports

Pulmonary embolism and renal artery thrombosis in a patient with patent foramen ovale

Carlo Bova et al. Acta Biomed. .

Abstract

Background and aim: Paradoxical embolism is a rare condition in which a thrombus migrates from the venous system to the arterial circulation, usually through a patent foramen ovale (PFO). Pulmonary embolism (PE) and isolated occlusion of one renal artery has been seldom reported.

Methods: We describe a case of a 47-year old white man with a one-month history of exertional dyspnea who was admitted to our hospital for severe pain in the right lumbar region.

Results: A computed tomography showed PE and a thrombotic occlusion of the right renal artery. A trans-thoracic echocardiogram documented a PFO with right to left shunt. Magnetic resonance imaging of the brain and venous compression ultrasonography of the lower extremities were normal. Therapeutic anticoagulation was started.

Conclusions: Pulmonary embolism and thrombotic occlusion of one renal artery is a rare manifestation of paradoxical embolism. Exertional dyspnea is an atypical manifestation of PE and can delay the diagnosis.

PubMed Disclaimer

Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Figures

Figure 1.
Figure 1.
Embolus of the right upper lobar pulmonary artery (arrow).
Figure 2.
Figure 2.
Right renal artery thrombosis (upper arrow) with hypo-perfused areas of the kidney (lower arrow).
Figure 3.
Figure 3.
Contrast echocardiography: contrast material in the left ventricle (arrows) as a consequence of right to left atrial shunt. vd, right ventricle; ad, right atrium; as, left atrium; vs, left ventricle.
See this image and copyright information in PMC

References

    1. Windecker S, Stortecky S, Meier B. Paradoxical Embolism. J Am Coll Cardiol. 2014;64:403–15. doi: 10.1016/j.jacc.2014.04.063. - PubMed
    1. Konstantinides S, Geibel A, Kasper W, Olschewski M, Blümel L, Just H. Patent foramen ovale is an important predictor of adverse outcome in patients with major pulmonary embolism. Circulation. 1998 May 19;97(19):1946–51. doi: 10.1161/01.cir.97.19.1946. - PubMed
    1. Le Moigne E, Timsit S, Ben Salem D, et al. Patent Foramen Ovale and Ischemic Stroke in Patients With Pulmonary Embolism: A Prospective Cohort Study. Ann Intern Med. 2019 Jun 4;170(11):756–763. doi: 10.7326/M18-3485. Epub 2019 May 7. - PubMed
    1. Zhang HL, Liu ZH, Luo Q, Wang Y, Zhao ZH, Xiong CM. Paradoxical embolism: Experiences from a single center. Chronic Dis Transl Med. 2017 Mar 30;3(2):123–128. doi: 10.1016/j.cdtm.2017.02.005. eCollection 2017 Jun 25. - PMC - PubMed
    1. Turkstra F, Kuijer PM, van Beek EJ, Brandjes DP, ten Cate JW, Büller HR. Diagnostic utility of ultrasonography of leg veins in patients suspected of having pulmonary embolism. Ann Intern Med. 1997 May 15;126(10):775–81. doi: 10.7326/0003-4819-126-10-199705150-00005. - PubMed

Publication types

MeSH terms

LinkOut - more resources