Treacherous Travelers: Emboli

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Presentation transcript:

Treacherous Travelers: Emboli Scott J. Cameron, MD, PhD, Elixabeth Laskurain, MD, Katarzyna Holcman, MD, J. Franklin Richeson, MD, Hanna Mieszczanska, MD The American Journal of Medicine Volume 128, Issue 7, Pages 695-698 (July 2015) DOI: 10.1016/j.amjmed.2015.01.038 Copyright © 2015 Elsevier Inc. Terms and Conditions

Figure 1 An electrocardiogram obtained on presentation showed a right bundle branch block, pathologic Q waves in leads III and aVF, and deep anterior T-wave inversions. The American Journal of Medicine 2015 128, 695-698DOI: (10.1016/j.amjmed.2015.01.038) Copyright © 2015 Elsevier Inc. Terms and Conditions

Figure 2 Computed tomography of the chest with contrast demonstrated a right main pulmonary artery filling defect (arrowhead) consistent with a large thrombus. The American Journal of Medicine 2015 128, 695-698DOI: (10.1016/j.amjmed.2015.01.038) Copyright © 2015 Elsevier Inc. Terms and Conditions

Figure 3 Transesophageal echocardiography provided a bicaval view of the heart. (A) The arrowhead by Doppler flow velocity indicates flow acceleration (red arrowhead) from RA to LA through a patent foramen ovale (white arrow). (B) After injection into a right upper-extremity intravenous line, saline contrast, in the form of bubbles (red arrowhead), appeared after 1 heartbeat in the LA. LA = left atrium; PFO = patent foramen ovale; RA = right atrium. The American Journal of Medicine 2015 128, 695-698DOI: (10.1016/j.amjmed.2015.01.038) Copyright © 2015 Elsevier Inc. Terms and Conditions

Figure 4 Possible mechanisms for simultaneous pulmonary embolus (PE) and ischemic cerebrovascular accident (CVA) are illustrated. LH = left heart; RH = right heart. The American Journal of Medicine 2015 128, 695-698DOI: (10.1016/j.amjmed.2015.01.038) Copyright © 2015 Elsevier Inc. Terms and Conditions