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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.<\/jats:p>","DOI":"10.1136\/bcr-2021-244284","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T12:40:29Z","timestamp":1632314429000},"page":"e244284","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Stroke and refractory hypoxaemia: complications of pulmonary embolism"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6627-2602","authenticated-orcid":false,"given":"Mafalda S\u00e1","family":"Pereira","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Homem","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiago","family":"Judas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0570-0818","authenticated-orcid":false,"given":"Francisca","family":"Delerue","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"2025082707250493000_14.9.e244284.1","doi-asserted-by":"crossref","first-page":"I","DOI":"10.1177\/2396987321989865","article-title":"European stroke organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke","volume":"6","author":"Berge","year":"2021","journal-title":"Eur Stroke J"},{"key":"2025082707250493000_14.9.e244284.2","doi-asserted-by":"crossref","first-page":"3453","DOI":"10.1093\/eurheartj\/ehz726","article-title":"The 2019 ESC guidelines on the diagnosis and management of acute pulmonary embolism","volume":"40","author":"Konstantinides","year":"2019","journal-title":"Eur Heart J"},{"key":"2025082707250493000_14.9.e244284.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1302097"},{"key":"2025082707250493000_14.9.e244284.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.09.027"},{"key":"2025082707250493000_14.9.e244284.5","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ijcard.2018.12.062","article-title":"Derivation and external validation of the shield score for predicting outcome in normotensive pulmonary embolism","volume":"281","author":"Freitas","year":"2019","journal-title":"Int J Cardiol"},{"key":"2025082707250493000_14.9.e244284.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005544"},{"key":"2025082707250493000_14.9.e244284.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.04.020"},{"key":"2025082707250493000_14.9.e244284.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.04.008"},{"key":"2025082707250493000_14.9.e244284.9","unstructured":"Carroll JD . RESPECT: a prospective randomized trial of PFO closure in patients with cryptogenic stroke\u2014long\u2010term results. TCT, 2015. Available: https:\/\/www.tctmd.com\/slide\/respect-prospective-randomized-trial-pfo-closure-patients-cryptogenic-stroke-long-term-0"},{"key":"2025082707250493000_14.9.e244284.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705915"},{"key":"2025082707250493000_14.9.e244284.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707404"},{"key":"2025082707250493000_14.9.e244284.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.046"},{"key":"2025082707250493000_14.9.e244284.13","doi-asserted-by":"crossref","first-page":"17","DOI":"10.7812\/TPP\/17-061","article-title":"Refractory hypoxemia in a patient with submassive pulmonary embolism and an intracardiac shunt: a case report and review of the literature","volume":"22","author":"Liew","year":"2018","journal-title":"Perm J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:25:14Z","timestamp":1756304714000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":13,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,22]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/bcr-2021-244284"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244284","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}