Thrombus straddling the patent foramen ovale: a case report
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By
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Qin Jiangyan
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Dan Li
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Shi Mengrong
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Hu Zitao
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July 7, 2026
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Clinical Scorecard: Transseptal Thrombus Across a Patent Foramen Ovale: A Clinical Case Study
At a Glance
| Category | Detail |
|---|
| Condition | Transseptal Thrombus Across a Patent Foramen Ovale |
| Key Mechanisms | Paradoxical embolism due to a patent foramen ovale allowing venous emboli to cross from the right to the left atrium. |
| Target Population | Patients with patent foramen ovale and suspected thromboembolic events. |
| Care Setting | Emergency and inpatient care settings. |
Key Highlights
- Transseptal thrombus is a rare but critical finding indicating potential paradoxical embolism.
- Contrast-enhanced cardiac CT is vital for diagnosing transseptal thrombus.
- Anticoagulation therapy was successfully implemented in the reported case.
Guideline-Based Recommendations
Diagnosis
- Use contrast-enhanced CT angiography for identifying transseptal thrombus.
Management
- Initiate anticoagulation therapy as the primary management strategy.
Monitoring & Follow-up
- Follow-up assessments at 1, 3, 6, 12 months post-discharge to monitor for symptoms and adherence.
Risks
- Consider the risks of thrombolysis and surgery versus the benefits of anticoagulation.
Patient & Prescribing Data
Elderly patients with acute dyspnea and evidence of thromboembolism.
Rivaroxaban was prescribed, starting at 15 mg twice daily, transitioning to 20 mg once daily.
Clinical Best Practices
- Ensure timely recognition of transseptal thrombus to prevent systemic embolism.
- Engage in shared decision-making with patients regarding management options.
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