Cerebral strokes of unknown origin frequently present with a patent foramen ovale (PFO), a common atrial septal defect occurring in approximately 25% of the adult population. Deep vein thrombosis (DVT) or pulmonary embolism (PE) in the presence of a PFO can produce paradoxical systemic embolization subsequent to an increase in pulmonary pressure, permitting entry of thrombi into the arterial ci...

THE EFFECTIVE management of massive pulmonary embolism remains a challenge. The successful treatment rests primarily upon early operative intervention and survival without surgery is extremely low. In the series of sixty-five patients of Hampson, Milne & Small (1961) all but nine died immediately. Donaldson et al. (1963) reviewing 271 cases of massive pulmonary embolism, proved at autopsy, reve...

A 26 year old Saudi man with features of both Loeffer's endocarditis and endomyocardial fibrosis presented with mild symptoms and pulmonary emboli. Echocardiographic examination showed obliteration of the right ventricular apex by an attached mass. The results of haemodynamic studies were somewhat abnormal and medical treatment was started. Despite anticoagulation with warfarin the patient's co...

While most of pulmonary thromboembolism (PE) cases can be managed by thrombolytic and anticoagulation therapy, massive PE remains a life-threatening disease. Although surgical embolectomy can be a curative therapy for massive PE, peri-operative mortality for hemodynamically collapsed PE is extremely high. We present a case of hemodynamically collapsed massive PE. We avoided either thrombolytic ...

Paradoxical embolism is defined as venous thrombosis causing systemic embolization through a right-to-left shunt. We, herein, report a case of bilateral total knee arthroplasty and developed paradoxical embolism caused by patent foramen ovale. A sixty-two-year-old female had a simultaneous, total knee arthroplasty for primary osteo-arthritis. A pulmonary emboli was suspected on the thirteenth p...

THE EFFECTIVE management of massive pulmonary embolism remains a challenge. The successful treatment rests primarily upon early operative intervention and survival without surgery is extremely low. In the series of sixty-five patients of Hampson, Milne & Small (1961) all but nine died immediately. Donaldson et al. (1963) reviewing 271 cases of massive pulmonary embolism, proved at autopsy, reve...

INTRODUCTION Entrapped thrombus in a patent foramen ovale is a rare form of right heart thromboembolism. Various treatments have been used, such as anti-coagulation and thrombolytic therapy, vena cava filter, percutaneous thrombectomy and surgical embolectomy. CASE PRESENTATION A 60-year-old Kosovan woman was admitted to our hospital with a massive bilateral pulmonary thromboembolism, entrapp...

BACKGROUND Venous thromboembolic disease is among the most common causes of morbidity and mortality during pregnancy. The clinical evaluation alone is insufficient for the diagnosis of venous thromboembolic disease, and the normal pregnant state makes this evaluation even more challenging. DIAGNOSIS Objective testing is the mainstay of diagnosis, including compression ultrasound, impedance pl...

Acute massive pulmonary embolism is an emergency requiring immediate treatment. The right heart functional reserve is the major determinant of acute survival. Because most of the deaths resulting from the initial haemodynamic insult occur either immediately or within a few hours, the relief of pulmonary vascular obstruction must be as fast as possible. This can be achieved by thrombolytic treat...