Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale

Yeak, Raymond; Liew, Siew Khei

doi:10.5152/j.aott.2020.20035

Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale

Raymond DK YEAK, (University Putra Malaysia, School of Medicine and Health Sciences, Department of Orthopaedic Surgery, Selangor, Malaysias)

Siew Khei LIEW (University Putra Malaysia, School of Medicine and Health Sciences, Department of Orthopaedic Surgery, Selangor, Malaysias)

Acta Orthopaedica et Traumatologica Turcica

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Yıl: 2020 Cilt: 54 Sayı: 4 Sayfa Aralığı: 465 - 468 Metin Dili: İngilizce DOI: 10.5152/j.aott.2020.20035 İndeks Tarihi: 25-11-2020

Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale

Öz:

We present a rare case of a patient with concurrent fat embolism and pulmonary embolism, in a closed femur fracture withpatent foramen ovale (PFO). A 24-year-old man was involved in a motor vehicle accident with a closed left midshaft femurfracture. He developed fat embolism syndrome (FES) on day 3 of admission, and plating was performed. The D-dimer concentration was also high, which raised the suspicion of pulmonary artery embolism. Computed tomography pulmonary angiography (CTPA) revealed right inferior lobar pulmonary artery embolism and FES. A transthoracic echocardiogram (TEE) wasperformed, which showed a PFO. The presence of a PFO in patients with pulmonary embolism increases the risk of systemicembolism. Therefore, we recommend the routine echocardiogram for patients with pulmonary embolism to exclude any cardiac defect in causing right-to-left shunts, which predisposes the patient to paradoxical embolism.

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Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Bibliyografik

1. Allardyce DB, Meek RN, Woodruff B, Cassim MM, Ellis D. Increasing our knowledge of the pathogenesis of fat embolism: A prospective study of 43 patients with fractured femoral shafts. J Trauma 1974; 14: 955-62. [Crossref]
2. ten Duis HJ, Nijsten MW, Klasen HJ, Binnendijk B. Fat embolism in patients with an isolated fracture of the femoral shaft. J Trauma 1988; 28: 383-90. [Crossref]
3. Konstantinides S, Geibel A, Kasper W, Olschewski M, Blümel L, Just H. Patent foramen ovale is an important predictor of adverse outcome in patients with major pulmonary embolism. Circulation 1998; 97: 1946-51. [Crossref]
4. Gurd AR. Fat embolism: An aid to diagnosis. J Bone Joint Surg Br 1970; 52B: 732-7 [Crossref]
5. Mellor A, Soni N. Fat embolism. Anaesthesia 2001; 56: 145-54. [Crossref]
6. Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006; 354: 2317-27. [Crossref]
7. Homma S, Sacco RL. Patent foramen ovale and stroke. Circulation 2005; 112: 1063-72. [Crossref]
8. Rosamond W, Flegal K, Furie K, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2008 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008; 117: e25-146. [Crossref]
9. Pilgrim T, Meier B, Khattab AA. Death by patent foramen ovale in a soccer player. J Invasive Cardiol 2013; 25: 162-4.
10. Kellogg RG, Fontes RBV, Lopes DK. Massive cerebral involvement in fat embolism syndrome and intracranial pressure management. J Neurosurg 2013; 119: 1263-70. [Crossref]
11. Le Moigne E, Timsit S, Ben Salem D, et al. Patent Foramen ovale and ischemic stroke in patients with pulmonary embolism: A prospective cohort study. Ann Intern Med 2019; 170: 756-63. [Crossref]
12. Gossling HR, Pellegrin VD. Fat embolism syndrome. A review of the pathophysiology and physiologic basis of treatment. Clin Orthop Relat Res 1982; 56: 408-16.
13. Chuang EL, Miller FS, Kalina RE. Retinal lesions following long bone fractures. Ophthalmology 1985; 92: 370-4. [Crossref]
14. de Moraes AG, Vakil A, Moua T. Patent foramen ovale in idiopathic pulmonary arterial hypertension: Long-term risk and morbidity. Respir Med 2016; 118: 53-57. [Crossref]
15. Favilla CG, Messé SR. New data support patent foramen ovale closure after stroke. Stroke 2018; 49: 262-4. [Crossref]

APA	Yeak R, Liew S (2020). Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. , 465 - 468. 10.5152/j.aott.2020.20035
Chicago	Yeak Raymond,Liew Siew Khei Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. (2020): 465 - 468. 10.5152/j.aott.2020.20035
MLA	Yeak Raymond,Liew Siew Khei Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. , 2020, ss.465 - 468. 10.5152/j.aott.2020.20035
AMA	Yeak R,Liew S Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. . 2020; 465 - 468. 10.5152/j.aott.2020.20035
Vancouver	Yeak R,Liew S Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. . 2020; 465 - 468. 10.5152/j.aott.2020.20035
IEEE	Yeak R,Liew S "Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale." , ss.465 - 468, 2020. 10.5152/j.aott.2020.20035
ISNAD	Yeak, Raymond - Liew, Siew Khei. "Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale". (2020), 465-468. https://doi.org/10.5152/j.aott.2020.20035

APA	Yeak R, Liew S (2020). Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. Acta Orthopaedica et Traumatologica Turcica, 54(4), 465 - 468. 10.5152/j.aott.2020.20035
Chicago	Yeak Raymond,Liew Siew Khei Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. Acta Orthopaedica et Traumatologica Turcica 54, no.4 (2020): 465 - 468. 10.5152/j.aott.2020.20035
MLA	Yeak Raymond,Liew Siew Khei Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. Acta Orthopaedica et Traumatologica Turcica, vol.54, no.4, 2020, ss.465 - 468. 10.5152/j.aott.2020.20035
AMA	Yeak R,Liew S Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. Acta Orthopaedica et Traumatologica Turcica. 2020; 54(4): 465 - 468. 10.5152/j.aott.2020.20035
Vancouver	Yeak R,Liew S Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale. Acta Orthopaedica et Traumatologica Turcica. 2020; 54(4): 465 - 468. 10.5152/j.aott.2020.20035
IEEE	Yeak R,Liew S "Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale." Acta Orthopaedica et Traumatologica Turcica, 54, ss.465 - 468, 2020. 10.5152/j.aott.2020.20035
ISNAD	Yeak, Raymond - Liew, Siew Khei. "Concomitant fat embolism syndrome and pulmonary embolism in a patient with patent foramen ovale". Acta Orthopaedica et Traumatologica Turcica 54/4 (2020), 465-468. https://doi.org/10.5152/j.aott.2020.20035