Abstract
Paradoxical embolization has been clinically described as the triad of systemic (arterial) embolization, evidence of venous thrombosis, and evidence of an intracardiac communication between the two circulatory systems, right and left. A case of recurrent venous embolization, manifested both as apparent paradoxical arterial embolization and multiple pulmonary embolization, is presented. It is likely that the venous embolic events had been of a recurrent and episodic nature, thus giving rise to an element of pulmonary hypertension over time, and consequently the disturbed cardiopulmonary hemodynamics produced a right-to-left atrial shunt. A review of the literature suggests that clinically significant paradoxical embolization may be more frequent than is presently recognized and may be easily misdiagnosed unless included in the differential diagnosis.
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