Concomitant submassive pulmonary embolism and paradoxical embolic stroke after a long flight: Which is the optimal treatment?

Pier Camillo Pavesi, Chiara Pedone, Michela Crisci, Alberto Piacentini, Maria Fulvi, Giuseppe Di Pasquale

Research output: Contribution to journalArticlepeer-review

Abstract

Economy class stroke syndrome consists of ischemic stroke due to paradoxical embolism through patent foramen ovale after a long flight. Few cases have been described in the literature to date. The treatment choice could be tricky.We present the case of a 65-year-old woman, admitted for submassive pulmonary embolism after a long flight, that presented a paradoxical embolic stroke through patent foramen ovale shortly after. The patient was treated with intravenous thrombolysis within 1 h of stroke onset with a definite symptoms improvement. Afterwards, intravenous unfractioned heparin was started with strict partial thromboplastin time monitoring. Cerebral computed tomography scan, obtained after 24 and 72 h, ruled out hemorrhage. Warfarin was started after 72 h. Patent foramen ovale was percutaneously closed 3 months after.In the reported case, the treatment with thrombolysis and subsequent heparin infusion was effective and safe. We discuss the rationale for this treatment in the light of literature data.

Original languageEnglish
Pages (from-to)1070-1073
Number of pages4
JournalJournal of Cardiovascular Medicine
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 2008

Keywords

  • Paradoxical stroke
  • Pulmonary embolism
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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