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Stroke and refractory hypoxaemia: complications of pulmonary embolism
  1. Mafalda Sá Pereira,
  2. Rita Homem,
  3. Tiago Judas and
  4. Francisca Delerue
  1. Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal
  1. Correspondence to Dr Francisca Delerue; mafalda.pereira{at}


Acute pulmonary embolism is one of the main causes of cardiovascular mortality. Treatment should be guided according to mortality risk stratification, but an individualised and multidisciplinary approach is often required. Concomitant persistent hypoxaemia can be present in cases of intracardiac shunt. In this report, we describe a 46-year-old woman with a history of surgery, presenting with pulmonary embolism with refractory hypoxaemia and simultaneous ischaemic stroke. Fibrinolysis was successfully performed, and the patient made a full recovery. Additional investigations identified a patent foramen ovale, which was later closed. She had no recurrent thrombotic events.

  • venous thromboembolism
  • stroke
  • cardiovascular medicine

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  • Contributors All authors contributed to the case. MSP contributed to patient management, planning, reporting, conception and design, acquisition of data and manuscript writing. RH contributed to patient management, planning and manuscript review. TJ contributed to patient management, planning, manuscript writing and review. FD contributed to manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.