A Rare Case of Paradoxical Embolization During Thrombolysis for Pulmonary Embolus

NCJ_cover.jpgBy Mitchell Onwochei-Ashei, William T. McGee

Neurocritical Care, April 2019, Volume 30, Issue 2, pp 484–486

Paradoxical embolization occurs when an embolus formed in the systemic venous circulation enters the systemic arterial circulation via an intracardiac shunt. The most common intracardiac shunt is a patent foramen ovale (PFO) present in approximately 25% of adults [1]. Other shunts which could allow for paradoxical embolization to occur include atrial septal defect, ventricular septal defect or extracardiac communications such as a pulmonary arteriovenous malformation [2].