ABSTRACT
Paradoxical embolism is the result of systemic arterial embolism and pulmonary embolism. It indicates the presence of an intracardial defect in the area of the atrial or ventricular septum. The most frequent cause of an intracardiac defect associated with paradoxical embolism is a patent foramen ovale (PFO). In the case presented here, the symptoms, diagnostics and surgical therapy are discussed.
Subject(s)
Brachiocephalic Trunk , Embolism, Paradoxical/etiology , Foramen Ovale, Patent/complications , Pulmonary Artery , Brachiocephalic Trunk/diagnostic imaging , Brachiocephalic Trunk/surgery , Cardiac Surgical Procedures , Echocardiography, Transesophageal , Embolectomy , Embolism, Paradoxical/diagnosis , Embolism, Paradoxical/therapy , Female , Foramen Ovale, Patent/diagnosis , Foramen Ovale, Patent/therapy , Humans , Middle Aged , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Thrombolytic Therapy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The heart can be the primary target for a viral, bacterial or parasitic infection (primary myocarditis/inflammatory cardiomyopathy). It can also participate in the "collateral damage" due to toxins, chemo- and cytokines, autoreactive antibodies or the native and acquired immune response through T- and B-cells, monocytes and macrophages (secondary myocarditis/inflammatory cardiomyopathy), when it is not the dominant organ of the disease. Infective agents show remarkable organ specificity: viral infections, toxic and autoreactive processes affect primarily the myocardium and the pericardium, whereas bacterial infections prefer endothelial surfaces and cause endocarditis and, less frequently, pericarditis. They are even discussed as part of the inflammatory process involved in coronary artery disease. Infective agents and their adequate diagnosis and treatment are discussed for these clinical entities according to current guidelines and clinical pathways.
