Case Report

Clinical and Experimental Nephrology

, Volume 15, Issue 1, pp 147-150

First online:

A suspected case of paradoxical renal embolism through the patent foramen ovale

  • Masaki IwasakiAffiliated withDivision of Nephrology, Toho University Ohashi Medical Center
  • , Nobuhiko JokiAffiliated withDivision of Nephrology, Toho University Ohashi Medical Center Email author 
  • , Yuri TanakaAffiliated withDivision of Nephrology, Toho University Ohashi Medical Center
  • , Hidehiko HaraAffiliated withDivision of Cardiovascular Medicine, Toho University Ohashi Medical Center
  • , Makoto SuzukiAffiliated withDivision of Cardiovascular Medicine, Toho University Ohashi Medical Center
  • , Hiroki HaseAffiliated withDivision of Nephrology, Toho University Ohashi Medical Center

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Abstract

We experienced a case of cryptogenic renal infarction in a previously healthy 60-year-old man. He had no systemic atherosclerotic changes. Holter monitoring revealed no atrial fibrillation. Transthoracic echocardiography showed no thrombus. Because the onset occurred while he was swinging a golf club (a similar maneuver to holding the breath), further examination was performed with a view to detecting paradoxical embolism through the foramen ovale. A positive bubble test with the Valsalva maneuver during transesophageal echocardiography led to the diagnosis of patent foramen ovale (PFO). This was a suspected case of paradoxical embolism through a PFO leading to renal infarction.

Keywords

Renal infarction Paradoxical embolism Valsalva maneuver Patent foramen ovale