Atrial septal defect paradoxical emboli

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Ostium Secundum Atrial Septal Defect
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [[4]]

Overview

Normally the emboli originating from the venous thrombus goes to the lung leading to pulmonary complications. However, in patients with atrial septal defects, a emboli can enter the arterial system through the defect. This may lead to rare complications like stroke and migraine. However, these defects are more common in patent forman ovale compared to atrial septal defect.

Paradoxical emboli

Venous thrombi (clots in the veins) are quite common. Embolization (dislodgement of thrombi) normally go to the lung and cause pulmonary emboli. In an individual with ASD, these emboli can potentially enter the arterial system [1], [2]. This can cause any phenomenon that is attributed to acute loss of blood to a portion of the body, including cerebrovascular accident (stroke), infarction of the spleen or intestines, or even a distal extremity (i.e.: finger or toe).

This is known as a paradoxical embolus because the clot material paradoxically enters the arterial system instead of going to the lungs.

References

  1. Loscalzo J (1986). "Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options". Am Heart J. 112 (1): 141–5. PMID 3728270.
  2. Ward R, Jones D, Haponik EF (1995). "Paradoxical embolism. An underrecognized problem". Chest. 108 (2): 549–58. PMID 7634897.


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