{"id":7642,"date":"2022-11-22T13:00:22","date_gmt":"2022-11-22T10:00:22","guid":{"rendered":"https:\/\/urbancare.clinic\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\/"},"modified":"2022-11-22T13:00:22","modified_gmt":"2022-11-22T10:00:22","slug":"spectre-clinique-large-dembolie-paradoxale","status":"publish","type":"post","link":"https:\/\/urbancare.clinic\/fr\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\/","title":{"rendered":"Large spectre clinique de l&#039;embolie paradoxale"},"content":{"rendered":"<div><img decoding=\"async\" src=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/wide-ranging-clinical-spectrum-of-paradoxical-embolism.jpg\" class=\"ff-og-image-inserted\" style=\"display:none\"><\/div>\n<p><span class=\"highwire-journal-article-marker-start\"><\/span><\/p>\n<div class=\"section abstract\" id=\"abstract-1\" readability=\"31\">\n<h2>Abstrait<\/h2>\n<p id=\"p-1\">L&#039;objectif de cette revue est de relever l&#039;indice de suspicion d&#039;embolie paradoxale chez les g\u00e9n\u00e9ralistes. L&#039;examen est bas\u00e9 uniquement sur des rapports anecdotiques compil\u00e9s \u00e0 partir d&#039;EMBASE, MEDLINE, Googlescholar et Pubmed. Les termes de recherche \u00e9taient \u00ab embolie paradoxale \u00bb, \u00ab embolie pulmonaire \u00bb et \u00ab malformations art\u00e9rio-veineuses pulmonaires \u00bb. Il en est ressorti que l&#039;embolie paradoxale droite-gauche pouvait survenir avec ou sans embolie pulmonaire concomitante, et aussi avec et sans preuve de la pr\u00e9sence d&#039;une \u00ab embolie en transit \u00bb. Les sites potentiels d&#039;atteinte syst\u00e9mique unique ou multiple comprenaient le syst\u00e8me nerveux central, la circulation coronarienne, la circulation art\u00e9rielle r\u00e9nale, la circulation spl\u00e9nique, la circulation m\u00e9sent\u00e9rique et les membres. Dans de nombreux cas, les veines profondes des membres inf\u00e9rieurs \u00e9taient \u00e0 l&#039;origine de la thromboembolie. Dans d&#039;autres cas, les thrombus provenaient d&#039;un an\u00e9vrysme septal auriculaire, d&#039;un cath\u00e9ter veineux central, d&#039;un shunt art\u00e9rio-veineux li\u00e9 \u00e0 l&#039;h\u00e9modialyse, d&#039;un an\u00e9vrisme de la veine poplit\u00e9e, de la veine jugulaire interne, de la veine cave sup\u00e9rieure, d&#039;une malformation art\u00e9rio-veineuse pulmonaire, de la tricuspidie endocardite valvulaire (avec et sans embolie pulmonaire) et de l&#039;oreillette droite, respectivement. L&#039;AVC \u00e9tait de loin la manifestation syst\u00e9mique la plus courante d&#039;embolie paradoxale. Certains AVC \u00e9taient imputables \u00e0 des malformations art\u00e9rio-veineuses pulmonaires avec ou sans coexistence de shunts intracardiaques. Les cliniciens doivent avoir un indice de suspicion \u00e9lev\u00e9 pour l&#039;embolie paradoxale en raison de sa dimension temporelle lorsqu&#039;elle survient dans le contexte d&#039;une atteinte de la circulation intracr\u00e2nienne, de la circulation coronarienne, de la circulation m\u00e9sent\u00e9rique et de la circulation p\u00e9riph\u00e9rique des membres.<\/p>\n<\/div>\n<ul class=\"kwd-group\">\n<li class=\"kwd\">cardiologie<\/li>\n<li class=\"kwd\">neurologie<\/li>\n<\/ul>\n<p><span class=\"highwire-journal-article-marker-end\"><\/span><a href=\"http:\/\/pmj.bmj.com\/cgi\/content\/short\/98\/1166\/958?rss=1\">Source quotidienne m\u00e9dicale<\/a><\/p>\n<p>","protected":false},"excerpt":{"rendered":"<p>L&#039;objectif de cette revue est d&#039;augmenter l&#039;indice de suspicion d&#039;embolie paradoxale chez les g\u00e9n\u00e9ralistes. La revue est bas\u00e9e uniquement sur des rapports anecdotiques compil\u00e9s \u00e0 partir d&#039;EMBASE, MEDLINE, Googlescholar et Pubmed. Les termes de recherche \u00e9taient \u00ab embolie paradoxale \u00bb, \u00ab embolie pulmonaire \u00bb et \u00ab malformations art\u00e9rioveineuses pulmonaires \u00bb. Il en est ressorti que l&#039;embolie paradoxale droite-gauche pouvait survenir avec ou sans embolie pulmonaire concomitante, et \u00e9galement avec ou sans preuve de la pr\u00e9sence d&#039;un \u00ab embole en transit \u00bb. Les sites potentiels d&#039;atteinte syst\u00e9mique unique ou multiple comprenaient le syst\u00e8me nerveux central, la circulation coronaire, la circulation art\u00e9rielle r\u00e9nale, la circulation spl\u00e9nique, la circulation m\u00e9sent\u00e9rique et les membres. Dans de nombreux cas, les veines profondes des membres inf\u00e9rieurs \u00e9taient la source de la thromboembolie. Dans d&#039;autres cas, les thrombus provenaient respectivement d&#039;un an\u00e9vrisme du septum auriculaire, d&#039;une ligne veineuse centrale, d&#039;un shunt art\u00e9rioveineux li\u00e9 \u00e0 l&#039;h\u00e9modialyse, d&#039;un an\u00e9vrisme de la veine poplit\u00e9e, de la veine jugulaire interne, de la veine cave sup\u00e9rieure, d&#039;une malformation art\u00e9rioveineuse pulmonaire, d&#039;une endocardite de la valve tricuspide (avec et sans embolie pulmonaire) et de l&#039;oreillette droite. L&#039;accident vasculaire c\u00e9r\u00e9bral \u00e9tait de loin la manifestation syst\u00e9mique la plus courante de l&#039;embolie paradoxale. Certains accidents vasculaires c\u00e9r\u00e9braux \u00e9taient attribuables \u00e0 des malformations art\u00e9rioveineuses pulmonaires avec ou sans coexistence de shunts intracardiaques. Les cliniciens doivent avoir un indice de suspicion \u00e9lev\u00e9 pour l&#039;embolie paradoxale en raison de sa dimension sensible au temps lorsqu&#039;elle survient dans le contexte d&#039;une atteinte de la circulation intracr\u00e2nienne, de la circulation coronaire, de la circulation m\u00e9sent\u00e9rique et de la circulation p\u00e9riph\u00e9rique des membres.<\/p>","protected":false},"author":2,"featured_media":7643,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"Default","format":"standard","meta":{"page_builder":"","fifu_image_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/wide-ranging-clinical-spectrum-of-paradoxical-embolism.jpg","fifu_image_alt":"","footnotes":""},"categories":[185],"tags":[],"class_list":["post-7642","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-medical-articles"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Wide-ranging clinical spectrum of paradoxical embolism - Urban Care Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbancare.clinic\/fr\/spectre-clinique-large-dembolie-paradoxale\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Wide-ranging clinical spectrum of paradoxical embolism - Urban Care Clinic\" \/>\n<meta property=\"og:description\" content=\"The purpose of this review is to raise the index of suspicion for paradoxical embolism among generalists. The review is based solely on anecdotal reports compiled from EMBASE, MEDLINE, Googlescholar and Pubmed. Search terms were &lsquo;paradoxical embolism&#039;, &lsquo;pulmonary embolism&#039; and &lsquo;pulmonary arteriovenous malformations&#039;. What emerged was that right-to-left paradoxical embolism could occur with or without concurrent pulmonary embolism, and also with and without proof of the presence of an &lsquo;embolus-in-transit&#039;. Potential sites of single or multiple systemic involvement included the central nervous system, the coronary circulation, renal arterial circulation, splenic circulation, the mesenteric circulation and the limbs. In many cases, the deep veins of the lower limbs were the source of thromboembolism. In other cases, thrombi originated from an atrial septal aneurysm, from a central venous line, from a haemodialysis-related arterio-venous shunt, from a popliteal vein aneurysm, internal jugular vein, superior vena cava, from a pulmonary arteriovenous malformation, from tricuspid valve endocarditis (with and without pulmonary embolism) and from the right atrium, respectively. Stroke was by far the commonest systemic manifestation of paradoxical embolism. Some strokes were attributable to pulmonary arteriovenous malformations with or without coexistence of intracardiac shunts. Clinicians should have a high index of suspicion for paradoxical embolism because of its time-sensitive dimension when it occurs in the context of involvement of the intracranial circulation, coronary circulation, mesenteric circulation, and peripheral limb circulation.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/urbancare.clinic\/fr\/spectre-clinique-large-dembolie-paradoxale\/\" \/>\n<meta property=\"og:site_name\" content=\"Urban Care Clinic\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/urbancarezanzibar\" \/>\n<meta property=\"article:published_time\" content=\"2022-11-22T10:00:22+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/wide-ranging-clinical-spectrum-of-paradoxical-embolism.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"1024\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Urban Care Clinic\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Urban Care Clinic\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\\\/\"},\"author\":{\"name\":\"Urban Care Clinic\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#\\\/schema\\\/person\\\/a304a61bcf298680ee41e2e9ae193930\"},\"headline\":\"Wide-ranging clinical spectrum of paradoxical embolism\",\"datePublished\":\"2022-11-22T10:00:22+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\\\/\"},\"wordCount\":237,\"publisher\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/urbancare.clinic\\\/wp-content\\\/uploads\\\/2023\\\/02\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism.jpg\",\"articleSection\":[\"Research Articles\"],\"inLanguage\":\"fr-FR\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\\\/\",\"url\":\"https:\\\/\\\/urbancare.clinic\\\/wide-ranging-clinical-spectrum-of-paradoxical-embolism\\\/\",\"name\":\"Wide-ranging clinical spectrum of paradoxical embolism - 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In other cases, thrombi originated from an atrial septal aneurysm, from a central venous line, from a haemodialysis-related arterio-venous shunt, from a popliteal vein aneurysm, internal jugular vein, superior vena cava, from a pulmonary arteriovenous malformation, from tricuspid valve endocarditis (with and without pulmonary embolism) and from the right atrium, respectively. Stroke was by far the commonest systemic manifestation of paradoxical embolism. Some strokes were attributable to pulmonary arteriovenous malformations with or without coexistence of intracardiac shunts. 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