Cor Vasa 2011, 53(6-7):348-352 | DOI: 10.33678/cor.2011.086

Acute pulmonary embolism and patent foramen ovale - neglected risk association

Martin Hutyra^1,*, David Vindiš¹, Daniel Šaňák², Tomáš Skála¹

¹ I. interní klinika - kardiologická

² Neurologická klinika, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého, Olomouc, Česká republika

Patent foramen ovale (PFO) is a physiological variety characterized by the presence of a minimal shunt flow through the interatrial septum, with the incidence of 17-27% in a non-selected population. Acute pulmonary embolism is a relatively frequent heterogenic clinical entity with a variable clinical manifestation. Paradoxical embolization through PFO from the venous system is considered the basic pathogenetic mechanism. PFO morphology is one of the major risk determinants of this ischemic complication. Another possibility of embolization to brain circulation occurrence is in-situ thrombosis directly in the canal of PFO due to haemostasis or hypercoagulation.
Bidirectional flow through PFO is associated with a risk of silent strokes potentially leading to neurological disability and can present a serious socioeconomic problem. A demonstration of PFO with a bidirectional flow on transesophageal echocardiography is an indication for reperfusion therapy of pulmonary embolism in accordance with the Guidelines of the Czech Society of Cardiology.

Keywords: Pulmonary embolism; Patent foramen ovale; Paradoxical embolization; Thrombolysis; Echocardiography

Published: June 1, 2011  Show citation