Diagnosis and Pathophysiology of Paradoxical Embolism

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Abstract
Three cases of paradoxical embolism are presented. Although most systemic emboli originate in the heart, detection of other sources is aided by venography of the lower extremities, indocyanine green-dye curve studies of the inferior vena cava, obtaining right heart pressures, oximetry and pulmonary angiography. Of 55 patients, 40% reviewed had repeat episodes of systemic embolism and 2 of the 3 proved cases of paradoxical embolism had repeat episodes. Prolonged anticoagulant therapy may prevent recurrence.

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