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Figure 1. An obese 46-year-old man came to the emergency room with the acute onset of numbness and a cold feeling in both hands; he had had shortness of breath and chest pain for the preceding 48 hours. Physical examination showed that he had no radial pulses. After arteriography that revealed emboli involving the right brachial and left axillary arteries, the patient underwent bilateral brachial embolectomy, and normal circulation was restored. Because paradoxical embolism was strongly suspected, two-dimensional transesophageal echocardiography was performed with an omniplane transducer. Panel A shows an image of the heart in the oblique plane (50 . . . [Full Text of this Article] |