CASE REPORT article
Front. Cardiovasc. Med.
Sec. Thrombosis and Haemostasis
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1666061
This article is part of the Research TopicCase Reports in Thrombosis: 2025View all 10 articles
A patient with sudden pulmonary embolism and stroke after total hysterectomy and bilateral salpingo-oophorectomy was diagnosed with patent foramen ovale: case report and review
Provisionally accepted
- 1Department of Critical Care Medicine, Ninth Medical Center, General Hospital of the People's Liberation Army, Beijing, China
- 2Department of Cardiology, the Ninth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
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A 75-year-old woman was admitted for the treatment of uterine fibroids and underwent laparoscopic total hysterectomy with bilateral salpingo-oophorectomy under general anesthesia. On the first postoperative day, the patient experienced sudden convulsion followed by loss of consciousness while transitioning from a seated to standing position. Subsequent examinations revealed pulmonary embolism and partial thrombosis in the muscular veins of the right lower leg. Anticoagulant therapy was immediately initiated. On postoperative day 3, early morning, the patient was found to be agitated with a positive Babinski sign on the right side. A CT scan of the brain revealed a cerebral infarction. Following the sequential occurrence of pulmonary embolism and cerebral infarction, paradoxical embolism drew the physician's attention. After discussion, the cause was attributed to either an arteriovenous fistula or a patent foramen ovale. Subsequent transesophageal echocardiography (TEE) and bubble study confirmed a patent foramen ovale (PFO) in the patient. This case highlights the critical importance of proactively searching for underlying etiologies when faced with such abnormal clinical presentations.
Keywords: patent foramen ovale, Pulmonary Embolism, Cerebral Infarction, Paradoxical embolism, Status Post Total Hysterectomy with Bilateral Salpingo-Oophorectomy, case report
Received: 15 Jul 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Zhao, Wang, Zhao, Tian, Zhai and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mei Hu, Department of Critical Care Medicine, Ninth Medical Center, General Hospital of the People's Liberation Army, Beijing, China
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