Cor Vasa 2019, 61(6):635-639 | DOI: 10.33678/cor.2019.014

(Rapidly progressive early onset dementia as the first symptom of paradoxical embolism)

Jurij Talanov, Tomáš Roubíček, Jindřich Kupec, Rostislav Polášek

Kardiocentrum, Krajská nemocnice Liberec, a.s., Liberec

The most common cause of dementia in younger patients is Alzheimer's disease followed by vascular - most often multi-infarct dementia. Multi-infarct dementia is defined as a cognitive disorder caused by multiple lesions and infarctions in grey and white matter of the brain caused by occlusions of the arteries and arterioles. One of the possible causes of cardioembolic stroke is paradoxical embolism in patients with patent foramen ovale (PFO). We present a case of a 41-year-old man with rapidly progressive dementia with multi-infarct brain damage likely due to paradoxical embolism. He was diagnosed with PFO only after massive pulmonary embolism with mobile thrombus protruding to the left atrium. The patient was treated with a surgical embolectomy and suture-mediated PFO closure followed by anticoagulation therapy. In early onset dementia, it is crucial to recognize potentially reversible causes. One of them is aforementioned paradoxical embolism in patients with PFO which should be purposefully excluded in early stages of the disease.

Keywords: Early onset dementia, Paradoxical embolism, Patent foramen ovale

Received: March 3, 2019; Accepted: April 3, 2019; Published: December 15, 2019  Show citation