Cardiac Pathology: Paradoxical embolism

01 April 2011
Presented by Mary Sheppard.

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A 1948 autopsy specimen from a 65 year old man who had a routine sigmoid colectomy for malignancy. Two weeks after discharge he suddenly became distressed, dying a few minutes later. Autopsy showed bulky fresh pulmonary emboli, a left temporo-frontal infarct (due to paradoxical embolism) and the clot shown in the specimen - caught between right and left atria lying in the patent foramen ovale. Extensive right femoral deep vein thrombosis was present and had clearly provided the source of the clot.

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