Miraculous life-saving role of patent foramen ovale: a case report


  • Kirils Jeršovs Rīgas Stradiņš University, Faculty of Medicine, Riga, Latvia
  • Sofija Aveniņa Rīgas Stradiņš University, Faculty of Medicine, Riga, Latvia
  • Vladimirs Krutovs Rīgas Stradiņš University, Faculty of Medicine, Riga, Latvia
  • Artjoms Kaļiņins Clinical Diagnostics Center, Riga East University Hospital, Riga, Latvia




PFO, Impending paradoxical embolism, Immobilization


Patent foramen ovale (PFO) is a relatively uncommon anatomical variant that predisposes patients to several complications, such as atrial septal aneurysm, thromboembolism, stroke, platypnea-orthodeoxia, and paradoxical embolism. Despite this, in rare cases, PFO can be a life-saving factor. We present a 72-year-old man with a PFO and fulfilled Virchov’s triad after being stationary, dehydrated, and suffering from chronic venous insufficiency. A subsequent transesophageal echocardiogram revealed a large thrombus (approx. 20 cm in length) dwelling in the PFO in between both atria. In this case, PFO effectively saved the patient from such complications as pulmonary embolism and paradoxical embolism.


Metrics Loading ...


Ma X, Song L, Yang H, Xia J, Wu C, He Y. Impending Paradoxical Embolism. Ann Thoracic Surg. 2019;108(2):e73-e75.

Pottier P, Hardouin J, Lejeune S, Jolliet P, Gillet B, Planchon B. Immobilization and the risk of venous thromboembolism. A meta-analysis on epidemiological studies. Thrombosis Res. 2009;124(4):468-76.

Själander A, Jansson J-H, Bergqvist D, Eriksson H, Carlberg B, Svensson P. Efficacy and safety of anticoagulant prophylaxis to prevent venous thromboembolism in acutely ill medical inpatients: a meta-analysis. J Internal Med. 2008;263(1):52-60.

Silva GV. Patent foramen ovale. Tex Heart Inst J. 2014;41(3):306-8.

Di Tullio M, Sacco RL, Gopal A, Mohr JP, Homma S. Patent foramen ovale as a risk factor for cryptogenic stroke. Ann Intern Med. 1992;117(6):461-5.

Farjat-Pasos JI, Guedeney P, Houde C, Alperi A, Mesnier J, Côté M, et al. Transcatheter Closure of Patent Foramen Ovale in Patients With Peripheral (Noncerebrovascular) Embolism. J Invasive Cardiol. 2022;34(10):E720-5.

Kubler P, Gibbs H, Garrahy P. Platypnoea-orthodeoxia syndrome. Heart. 2000;83(2):221-3.

Liu K, Wang BZ, Hao Y, Song S, Pan M. The Correlation Between Migraine and Patent Foramen Ovale. Front Neurol. 2020;11:543485.

Pristipino C, Sievert H, D’Ascenzo F, Louis Mas J, Meier B, Scacciatella P et al. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur Heart J. 2018;40(38):3182-95.

Oda T, Fuji T, Kato Y, Fujita S, Kanemitsu N. Deep venous thrombosis after posterior spinal surgery. Spine (Phila Pa 1976). 2000;25(22):2962-7.

Rosner MK, Kuklo TR, Tawk R, Moquin R, Ondra SL. Prophylactic placement of an inferior vena cava filter in high-risk patients undergoing spinal reconstruction. Neurosurg Focus. 2004;17(4):E6.

Doğan M, Erat M, Sunman H, Yeter E. Successful treatment with anticoagulant therapy of a thrombus trapped in a patent foramen ovale in a patient with acute pulmonary embolism. Turk Kardiyol Dern Ars. 2015;43(7):660.

Rose PS, Punjabi NM, Pearse DB. Treatment of right heart thromboemboli. Chest. 2002;121(3):806-14.






Case Reports