Trans-esophageal contrast echocardiography in suspicion of paradoxal embolism

In two patients, women of 35 and 74 years old, paradoxical embolism was diagnosed. Patient A presented with multiple pulmonary embolism. Transoesophageal echocardiography demonstrated a thrombus mass which protruded from the right atrium through a patent foramen ovale into the left atrium: explicit proof of the possibility of paradoxical embolism. Patient B presented with systemic arterial embolism. During hospitalisation multiple pulmonary embolism occurred. With the use of transoesophageal contrast echocardiography a patent foramen ovale was observed, the probable cause of paradoxical embolism. Both patients were treated with intravenous heparin and oral anticoagulants.