Paradoxical embolism: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
Paradoxical embolism involves passage of a venous clot (thrombus) from a vein to an artery. When clots in veins break off (embolize), they travel first to the right side of the heart and, normally, then to the lungs where they lodge, causing [[pulmonary embolism]]. On the other hand, when there is a hole in the wall between the two upper chambers of the heart (an [[atrial septal defect]]), a clot can cross from the right to the left side of the heart, then pass into the arteries as a paradoxical embolism. Once in the arterial circulation, a clot can travel to the brain, block a vessel there, and cause a stroke (cerebrovascular accident). | Paradoxical embolism involves passage of a venous clot (thrombus) from a vein to an artery. When clots in veins break off (embolize), they travel first to the right side of the heart and, normally, then to the lungs where they lodge, causing [[pulmonary embolism]]. On the other hand, when there is a hole in the wall between the two upper chambers of the heart (an [[atrial septal defect]]), a clot can cross from the right to the left side of the heart, then pass into the arteries as a paradoxical embolism. Once in the arterial circulation, a clot can travel to the brain, block a vessel there, and cause a stroke (cerebrovascular accident). | ||
==Diagnosis== | |||
=== Echocardiography=== | |||
A bubble study can be useful in establishing the presence of right-to-left shunting in the evaluation of the patient with suspected paradoxical embolism. It should be noted that bidirectional shunting can also be associated with paradoxical embolism. | |||
==Treatment== | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Revision as of 23:59, 3 September 2011
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords:Paradoxical embolization, paradoxical embolus, cryptogenic stroke, crossed embolism
Overview
A paradoxical embolism is a cause of stroke or other form of arterial thrombosis that is caused by embolism of a thrombus (blood clot) of venous origin through a hole in the heart, typically an atrial septal defect.
Pathophysiology
Paradoxical embolism involves passage of a venous clot (thrombus) from a vein to an artery. When clots in veins break off (embolize), they travel first to the right side of the heart and, normally, then to the lungs where they lodge, causing pulmonary embolism. On the other hand, when there is a hole in the wall between the two upper chambers of the heart (an atrial septal defect), a clot can cross from the right to the left side of the heart, then pass into the arteries as a paradoxical embolism. Once in the arterial circulation, a clot can travel to the brain, block a vessel there, and cause a stroke (cerebrovascular accident).
Diagnosis
Echocardiography
A bubble study can be useful in establishing the presence of right-to-left shunting in the evaluation of the patient with suspected paradoxical embolism. It should be noted that bidirectional shunting can also be associated with paradoxical embolism.