Images in Intensive Medicine
An unexpected foramen ovale
Un foramen oval inesperado
Pablo Carrión Montaner
, Mario Sutil-Vega, Jordi Sans Roselló
Corresponding author
csv.pablo1@gmail.com
Corresponding author at: Servicio de Cardiología, Hospital Universitario Parc Taulí, Parc Taulí 1, 08208 Sabadell, Spain.
Corresponding author at: Servicio de Cardiología, Hospital Universitario Parc Taulí, Parc Taulí 1, 08208 Sabadell, Spain.
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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Blood pressure was recorded at 126/78<span class="elsevierStyleHsp" style=""></span>mmHg, 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 10<span class="elsevierStyleHsp" style=""></span>mm thrombus in the right pulmonary artery branch (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>-A) and an elongated 35<span class="elsevierStyleHsp" style=""></span>mm thrombus in the left branch (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>-B). After 24<span class="elsevierStyleHsp" style=""></span>hours, an elongated 11<span class="elsevierStyleHsp" style=""></span>cm thrombus (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>-arrow) was detected in transit through the interatrial septum (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>-asterisk). Surgical intervention was ultimately decided upon, and a pulmonary and cardiac thrombectomy followed by the closure of the patent foramen ovale were performed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">None declared. The patient gave his informed consent for both the publication of the case and the iconography.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Carrión Montaner P, Sutil-Vega M, Sans Roselló J. 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Med Intensiva. 2024. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.medin.2024.06.005">https://doi.org/10.1016/j.medin.2024.06.005</span></p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0020" class="elsevierStylePara elsevierViewall">The following are Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0015" ] ] ] ] "multimedia" => array:4 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 492 "Ancho" => 990 "Tamanyo" => 65859 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 506 "Ancho" => 990 "Tamanyo" => 40902 ] ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 572149 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 3 => array:5 [ "identificador" => "upi0010" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.mp4" "ficheroTamanyo" => 1338026 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/unassign/S2173572724001711/v1_202407020616/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/21735727/unassign/S2173572724001711/v1_202407020616/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572724001711?idApp=WMIE" ]
