Simultaneous cardiac and cerebral infarcts in a patient with hip fracture and previously unknown patent foramen ovale: management between Scylla and Charybdis by Dr Emily Walsh in Journal of Clinical Case Reports Medical Images and Health Sciences
Simultaneous cardiac and cerebral infarcts in a patient with hip fracture and previously unknown patent foramen ovale: management between Scylla and Charybdis by Dr Emily Walsh in Journal of Clinical Case Reports Medical Images and Health Sciences Abstract We report a rare case of an 84-year-old man with left femoral neck fracture who presented with three interrelated life-threatening pathologies–systemic hypoxaemia, simultaneous cardiac and watershed brain infarctions due to previously unknown patent foramen ovale (PFO) and septal defects with a right-to-left shunt. Computed tomography scans, magnetic resonance imaging and echocardiography (with bubble study) confirmed the diagnosis. The report describes diagnostic and treatment challenges, which required a multidisciplinary approach, provides possible explanations for these conditions, and discusses the therapeutic management (appropriateness of thrombolysis, use of antithrombotic, antiplatelet and antifibrinolytic drugs). The pati...