Is Routine Echocardiographic Examination Necessary for All Deep Venous Thrombosis? For a Recurrent Paradoxical Embolism Case

Although patent foramen ovale (PFO) is always considered as a benign embryonic defect, especially in patients with deep venous thrombus (DVT), it may lead to catastrophic results with its complications. In order to prevent dramatic consequences in patients with DVT or thrombus in inferior vena cava, cardiac investigation of these patients may be useful for diagnosing this clinical en- tity that gives late symptoms. A 43-year old female patient with chronic DVT and previous pulmonary emboli for two times hospitalized to implant vena cava filter. During hospital stay, one cerebral embolism and one coronary embolism attack observed, therefore an echocardiographic investigation was performed eventually PFO diagnosed. The aim of this article is to remind paradoxical embo- lism-an almost forgotten entitywith a recent case. We also want to emphasize that echocardiography may be useful to investigate the presence of right-to-left shunt in patients with DVT.