Abstract
Neurodegenerative diseases are defined as hereditary or acquired conditions which are characterized by progressive nervous system dysfunction. They include diseases such as Alzheimer’s Disease and other dementias, Huntington’s Disease, and so on. We report a case of 59-years-old man with Huntington Chorea admitted to our department for dyspnoea in massive pulmonary embolism due to a migration of a part of thrombus from deep venous thrombosis situs. He had recent history of pneumonia and severe hypomobility, and the thrombophilic screening showed a deficiency of C protein and S protein. While the diagnostic workup had been done, we discovered severe coronary disease, patent foramen ovale and paradoxical embolism.
Highlights
Called Foramen Botalli or Ostium Secundum of Born, is an anatomical interatrial communication which links the right atrium to the left atrium in the fetal heart [1]
Following the birth, when there is an increased blood return to the left atrium because the lungs have expanded, the septum primum should normally closed against the left side of the limbus of the fossa ovalis
In approximately 25% of individuals, the foramen ovale remains patent for life. In these persons there is a potential condition of paradoxical embolism of air, thrombotic materials and fat [1]
Summary
Called Foramen Botalli or Ostium Secundum of Born, is an anatomical interatrial communication which links the right atrium to the left atrium in the fetal heart [1]. His vital signs showed a pulse rate of 95 bpm, arterial blood pressure of 70/40 mmHg, respiratory rate of 24 breaths/min, and an oxygen saturation of 88%, breathing room air He had jugular venous distension and regular but distant heart sounds, with neither murmur nor rubs on cardiac auscultation. A 2D-Transthoracic Echocardiography (TTE) identified a big fluttering thrombus trapped in the foramen ovale which obstructed the left ventricular outflow tract, signs of paradoxical movement of atrial septum, moderate right heart stain (PAPs 70 mmHg), normal left ventricular volume and kinesis. The patient was discharged at the 10th postoperative day, the dismissed transthoracic echocardiography showed a normal volume and kinesis of right and left ventricles (pulmonary acceleration time 92 m.sec, E/A=1, PAPs 35 mmHg), a correct closure of foramen ovale without any shunt.
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