Impending Paradoxical Embolization: Caught in Flagrante Delicto

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Paradoxical embolism is a rare complication of venous thromboembolic disease. A thrombus in transit across the patent foramen ovale or other abnormal communication between the pulmonary and systemic circulations—impending paradoxical embolism—may be diagnosed or suspected at transthoracic echocardiography or computed tomography pulmonary angiography, and, if necessary, confirmed at transesophageal echocardiography. We present computed tomography and echocardiographic images of a 59-year-old man whose impending paradoxical embolism was successfully treated with unfractionated heparin.

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