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2 results

  • Chapter 13 - Physician as patient

  • Edited by Antonio Culebras
  • Book:
    Sleep, Stroke and Cardiovascular Disease
    Published online:
    05 January 2013
    Print publication:
    06 December 2012, pp 151-154

  • Summary

    The mechanism by which patent foramen ovale (PFOs) are associated with ischemic stroke is believed to be paradoxical embolism. It has been observed that people with migraine with aura have a larger than expected concomitant prevalence of PFO compared to people without migraine. Transient global amnesia is considered to have a similar pathophysiology to migraine, and an association with PFO has also been observed. The mechanisms by which obstructive sleep apnea (OSA) increases the risk of ischemic stroke are multiple and all contribute to the ischemic event. As the risk seems associated with the multiple physiological abnormalities that accompany OSA and facilitated by a PFO, stroke prevention could potentially be achieved by improving OSA and reducing the right-to-left shunt treatment, antithrombotic therapy, PFO closure. Antithrombotic therapy should be given as well, in light of the greater overall cardiovascular risk.

  • Paradoxical embolism: a rare life- and limb-threatening emergency

  • Christine E. Tang
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 6 / Issue 1 / January 2004
    Published online by Cambridge University Press:
    21 May 2015, pp. 40-44
    Print publication:
    January 2004
    • Article
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  • This article presents a case of a 43-year-old man with paradoxical embolism. The patient had simultaneous deep venous thrombosis, pulmonary embolism and bilateral limb-threatening arterial occlusions. The unifying diagnosis was paradoxical embolism through a previously undetected atrial septal defect. Suggestions for the evaluation and emergency management of paradoxical embolism are outlined, and the literature is briefly reviewed.