Impending paradoxical embolism: A case report and literature review

Paradoxical embolism occurs following the passage of embolicmaterial from the venous to the arterial circulation througha right to left shunt—frequently a patent foramen ovale.The diagnosis is usually presumptive when arterial emboli occurin the appropriate clinical setting. We describe a case of impendingparadoxical embolism in a patient with massive pulmonary embolism.Transoesophageal echocardiography revealed a thromboembolusstraddling a patent foramen ovale. The patient underwent emergencyremoval of the intracardiac clot with closure of the patentforamen ovale.