An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature

Controversies exist regarding the treatment of acute massive pulmonary embolism (PE) with anticoagulation alone or with thrombolytic therapy. Paradoxical embolism in the presence of a patent foramen ovale (PFO) is a rare but well-known entity and should always be looked for in case of a PE associate...

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Detalles Bibliográficos
Autores principales: Konala, Venu Madhav, Naramala, Srikanth, Adapa, Sreedhar, Aeddula, Narothama Reddy, Bose, Subhasish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Pulmonology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820670/
https://www.ncbi.nlm.nih.gov/pubmed/31695986
http://dx.doi.org/10.7759/cureus.5567
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author Konala, Venu Madhav
Naramala, Srikanth
Adapa, Sreedhar
Aeddula, Narothama Reddy
Bose, Subhasish
author_facet Konala, Venu Madhav
Naramala, Srikanth
Adapa, Sreedhar
Aeddula, Narothama Reddy
Bose, Subhasish
author_sort Konala, Venu Madhav
collection PubMed
description Controversies exist regarding the treatment of acute massive pulmonary embolism (PE) with anticoagulation alone or with thrombolytic therapy. Paradoxical embolism in the presence of a patent foramen ovale (PFO) is a rare but well-known entity and should always be looked for in case of a PE associated with systemic thromboembolism. We report a case of acute sub-massive PE treated with thrombolytic therapy in an elderly gentleman who had a paradoxical embolism and ischemic stroke as a result of a clot traversing through a PFO. We discussed diagnostic modalities, treatment of choice, and associated controversies in management. 
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spelling pubmed-68206702019-11-06 An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature Konala, Venu Madhav Naramala, Srikanth Adapa, Sreedhar Aeddula, Narothama Reddy Bose, Subhasish Cureus Pulmonology Controversies exist regarding the treatment of acute massive pulmonary embolism (PE) with anticoagulation alone or with thrombolytic therapy. Paradoxical embolism in the presence of a patent foramen ovale (PFO) is a rare but well-known entity and should always be looked for in case of a PE associated with systemic thromboembolism. We report a case of acute sub-massive PE treated with thrombolytic therapy in an elderly gentleman who had a paradoxical embolism and ischemic stroke as a result of a clot traversing through a PFO. We discussed diagnostic modalities, treatment of choice, and associated controversies in management.  Cureus 2019-09-04 /pmc/articles/PMC6820670/ /pubmed/31695986 http://dx.doi.org/10.7759/cureus.5567 Text en Copyright © 2019, Konala et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pulmonology
Konala, Venu Madhav
Naramala, Srikanth
Adapa, Sreedhar
Aeddula, Narothama Reddy
Bose, Subhasish
An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature
title An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature
title_full An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature
title_fullStr An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature
title_full_unstemmed An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature
title_short An Elderly Man with Syncope, Hypoxia, and Confusion: A Case Report and Review of Literature
title_sort elderly man with syncope, hypoxia, and confusion: a case report and review of literature
topic Pulmonology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820670/
https://www.ncbi.nlm.nih.gov/pubmed/31695986
http://dx.doi.org/10.7759/cureus.5567
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