The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

The Prevalence of Deep Venous Thrombosis in Patients with Suspected Paradoxical Embolism

Claudia Stollberger, MD; Jorg Slany, MD; Irmgard Schuster, MD; Hermann Leitner, MD; Walther-Benedikt Winkler, MD; and Ronald Karnik, MD
[+] Article, Author, and Disclosure Information

From Krankenanstalt Rudolfstiftung, Vienna, Austria. Request for Reprints: Claudia Stollberger, MD, Krankenanstalt Rudolfstiftung, A1030 Wien, Juchgasse 25, Austria. Acknowledgments: The authors thank Maria Burger for her assistance in performing the contrast studies, Lajos Csepoi and Dr. Friedrich Abzieher for preparation of the manuscript; and Dr. Barbara Schneider for statistical help.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(6):461-465. doi:10.7326/0003-4819-119-6-199309150-00003
Text Size: A A A

Objective: To determine the prevalence of venous thrombosis in patients with suspected paradoxical embolism.

Design: Observational study.

Patients: Two hundred sixty-four patients with clinically suspected embolic events underwent contrast transesophageal echocardiographic evaluation. Forty-nine patients (24 women, 25 men) had a patent foramen ovale. Forty-one patients had acute stroke, and 8 had acute limb ischemia.

Setting: Echocardiography laboratory of a community hospital.

Measurements: The presence of a patent foramen ovale was assessed by transesophageal contrast echocardiography. Forty-two patients had venographic evaluation of the lower-extremity venous system.

Results: Venous thrombosis was clinically suspected in 6 patients and documented in 24 of the 42 patients with patent foramen ovale who underwent venographic study (57%; 95% CI, 41% to 72%). Venous thrombosis was confined to calf or popliteal veins in 15 cases. Fifteen of 17 patients who had venographic evaluation within 7 days of the index event had thrombosis compared with 9 of 25 patients who had later evaluations (P = 0.001). More patients with venous thrombosis than without venous thrombosis had a history of previous thromboembolism (13 of 24 compared with 1 of 8, respectively; P = 0.001).

Conclusion: When a patent foramen ovale is detected in a patient with embolism, occult leg vein thrombosis is frequently present.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.