TY - JOUR
T1 - Concomitant submassive pulmonary embolism and paradoxical embolic stroke after a long flight
T2 - Which is the optimal treatment?
AU - Pavesi, Pier Camillo
AU - Pedone, Chiara
AU - Crisci, Michela
AU - Piacentini, Alberto
AU - Fulvi, Maria
AU - Di Pasquale, Giuseppe
PY - 2008/10
Y1 - 2008/10
N2 - 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.
AB - 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.
KW - Paradoxical stroke
KW - Pulmonary embolism
KW - Thrombolysis
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U2 - 10.2459/JCM.0b013e328306f2ea
DO - 10.2459/JCM.0b013e328306f2ea
M3 - Article
C2 - 18799974
AN - SCOPUS:55249107851
VL - 9
SP - 1070
EP - 1073
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 10
ER -