Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2025; 22 (4): 287-382 ➤ Множественный артериальный и венозный тромбоз у молодого пациента. Алгоритм ведения пациентов с подозрением на открытое овальное окно

Multiple arterial and venous thrombosis in a young patient. Algorithm of management in case of suspected patent foramen ovale

Authors: Zykov M.V.1 2, Zykova D.S.2, Butsev V.V. 2

Company:
1 Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russian Federation
2 City Hospital No. 4 of Sochi of Ministry of Health of Krasnodar Region, Sochi, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2025-22-4-366-375

UDC: 616.14-005.6:616.125.6-007.253

Link: Clinical Physiology of Blood Circulaiton. 2025; 22 (4): 366-375

Quote as: Zykov M.V., Zykova D.S., Butsev V.V. Multiple arterial and venous thrombosis in a young patient. Algorithm of management in case of suspected patent foramen ovale. Clinical Physiology of Circulation. 2025; 22 (4): 366–375 (in Russ.). DOI: 10.24022/1814-6910-2025-22-4-366-375

Keywords:  life-threatening paradoxical embolism patent foramen ovale thrombophilia

Received / Accepted:  21.10.2025 / 24.11.2025

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Abstract

Patent foramen ovale (PFO) is a minor structural anomaly of the heart, the prevalence of which is quite high and amounts to about 25–34%. The most formidable complication of PFO is "paradoxical embolism" (PE) – the entry of blood clots formed in the venous system through the PFO into the left atrium and, further, into the arteries of the systemic circulation. The uniqueness of the clinical case presented by the authors is that it clearly demonstrates the role of PFO in the development of life-threatening PE, with damage to multiple arterial basins. An algorithm is proposed that combines the approaches of neurologists, cardiologists and cardiovascular surgeons and even hematologists to determine the need to exclude PE in arterial thrombosis (stroke, myocardial infarction, thrombosis of peripheral arteries), to select the most important diagnostic and therapeutic measures.

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  1. Kavinsky C.J., Szerlip M., Goldsweig A.M., Amin Z., Boudoulas K.D., Carroll J.D. et al. SCAI guidelines for the management of patent foramen ovale. J. Soc. Cardiovasc. Angiogr. Interv. 2022; 1 (4): 100039. DOI: 10.1016/j.jscai.2022.100039
  2. Calvert P.A., Rana B.S., Kydd A.C., Shapiro L.M. Patent foramen ovale: anatomy, outcomes, and closure. Nat. Rev. Cardiol. 2011; 8 (3): 148–160. DOI: 10.1038/nrcardio.2010.224
  3. Yan C., Li H., Wang C., Yu H., Guo T., Wan L. et al. Frequency and size of in situ thrombus within patent foramen ovale. Stroke. 2023; 54: 1205–1213. DOI: 10.1161/STROKEAHA.122.041524
  4. D'Andrea A., Dweck M.R., Holte E., Fontes-Carvalho R., Cameli M., Aboumarie H.S. et al. EACVI survey on the management of patients with patent foramen ovale and cryptogenic stroke. Eur. Heart. J. Cardiovasc. Imaging. 2021; 22 (2): 135–141. DOI: 10.1093/ehjci/jeaa318
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About Authors

  • Mikhail V. Zykov, Dr. Med. Sci., Professor of the Department of Medical Rehabilitation, Head of the Department of Cardiology No. 1; ORCID
  • Dariya S. Zykova, Cand. Med. Sci., Cardiologist; ORCID
  • Vadim V. Butsev, Neurologist; ORCID

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