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Vol. 49. Issue 3.
Pages 186 (March 2025)
Images in Intensive Medicine
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An unexpected foramen ovale
Un foramen oval inesperado
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Pablo Carrión Montaner
Corresponding author
csv.pablo1@gmail.com

Corresponding author at: Servicio de Cardiología, Hospital Universitario Parc Taulí, Parc Taulí 1, 08208 Sabadell, Spain.
, Mario Sutil-Vega, Jordi Sans Roselló
Servicio de Cardiología, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
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A 64-year-old hypertensive man undergoing treatment with cisplatin for gastric adenocarcinoma presented to the emergencies with syncope. Blood pressure was recorded at 126/78mmHg, heart rate at 108 bpm, and an S1Q3T3 pattern was noted. The echocardiogram revealed the presence of a dilated right ventricle with a mobile mass in the right atrium and a lesion straddling the pulmonary trunk bifurcation. An angio-CT identified a 10mm thrombus in the right pulmonary artery branch (Fig. 1-A) and an elongated 35mm thrombus in the left branch (Fig. 1-B). After 24hours, an elongated 11cm thrombus (Fig. 2-arrow) was detected in transit through the interatrial septum (Fig. 2-asterisk). Surgical intervention was ultimately decided upon, and a pulmonary and cardiac thrombectomy followed by the closure of the patent foramen ovale were performed.

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Conflicts of interest

None declared. The patient gave his informed consent for both the publication of the case and the iconography.

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