• Manon C H de Vries, Kristine W A Koekkoek, Maurits J van der Veen, Marcory C R F van Dijk, and Dave H T Tjan.
• Ziekenhuis Gelderse Vallei, Ede.
• Ned Tijdschr Geneeskd. 2015 Jan 1; 159: A9491.

BackgroundA "thrombus in transit" is a relatively rare diagnosis involving a thrombus in a patent foramen ovale. Patent foramen ovale occurs in about 25% of the population. A thrombus in transit may lead to paradoxical arterial emboli in the cerebral circulatory system and the extremities, as well as other locations.Case DescriptionA 60-year-old male patient with severe pneumonia sepsis appeared to have a thrombus in the right atrium, extending into the left atrium through a patent foramen ovale. The patient was treated with therapeutic anticoagulants. Cerebral embolization occurred despite this, with extensive cerebral ischaemia. The patient ultimately died from multiple organ failure.ConclusionA thrombus in transit may be treated with heparins, thrombolysis or by surgical removal of the thrombus. The optimum treatment must be decided for each individual patient. The mortality rate of this condition is high (16-36%).

19 keywords...

hide…